Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study

Frontiers in Neurology

Neurology

Stein Silva¹  Bertrand Sauneuf²  Jonathan Chelly³  Olivier Lesieur⁴  Pierrick Cronier⁵  Cedric Daubin⁶  Alain Cariou⁷  Laurent Argaud⁸  Nicolas Deye⁹  Gwenhael Colin^1,10  Jean-Baptiste Lascarrou^1,11  Thomas Geeraerts^1,12  Marc Simon^1,13  Charles Cerf^1,14  Pascal Beuret^1,15  Sebastien Perbet^1,16  Julien Mayaux^1,17  Hamid Merdji^1,18  Bernard Cholley^1,19  Marc Danguy des Déserts^2,20  Michael Piagnerelli^2,21  Frederic Jacobs^2,22  Abdelkader Ouchenir^2,23  Antoine Lafarge^2,24  Nicolas Pichon^2,25  Vincent Das^2,26  Marie Salvetti^2,27  Gwenaelle Jacq^2,27  Marine Paul^2,27  Louise de Charentenay^2,27  Stephane Legriel^2,28  Christophe Guitton^2,29  Guillaume Schnell^3,30  Guillaume Thiery^3,31  Maleka Schenck^3,32  Jean-Pierre Quenot^3,33 

[1] AfterROSC, Paris, France;Critical Care Unit, University Teaching Hospital of Purpan, Toulouse, France;AfterROSC, Paris, France;General Intensive Care Unit, Cotentin Public Hospital Centre, Cherbourg-en-Cotentin, France;AfterROSC, Paris, France;Intensive Care Unit, Groupe Hospitalier Sud Ile de France, Melun, France;AfterROSC, Paris, France;Intensive Care Unit, Saint-Louis Hospital, La Rochelle, France;AfterROSC, Paris, France;Intensive Care Unit, Sud-Francilien Hospital Center, Corbeil-Essonnes, France;AfterROSC, Paris, France;Medical Intensive Care Unit, Caen Teaching Hospital, Caen, France;AfterROSC, Paris, France;Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Paris, France;INSERM U970, Paris Cardiovascular Research Centre, Paris, France;AfterROSC, Paris, France;Medical Intensive Care Unit, Hospices Civils de Lyon, Edouard Herriot Teaching Hospital, Lyon, France;AfterROSC, Paris, France;Medical Intensive Care Unit, Lariboisière University Hospital, APHP, Paris, France;INSERM UMR-S 942, Lariboisière Hospital, Paris, France;AfterROSC, Paris, France;Medical-Surgical Intensive Care Unit, La Roche-sur-Yon District Hospital Centre, La Roche-sur-Yon, France;AfterROSC, Paris, France;Medicine Intensive Reanimation, University Hospital, Nantes, France;Department of Anaesthesiology, Critical Care and Perioperative Medicine, Toulouse University Hospital, Toulouse, France;Department of Intensive Care, Cliniques du Sud-Luxembourg of Arlon, Arlon, Belgium;Department of Intensive Care, Foch Hospital, Suresnes, France;Department of Intensive and Continuous Care, Roanne Hospital, Roanne, France;Department of Perioperative Medicine, University Hospital of Clermont-Ferrand, 58 Rue Montalembert, Université Clermont Auvergne, CNRS, INSERM, GReD, Clermont-Ferrand, France;Department of Pulmonology and Intensive Care, Pitié-Salpêtrière Teaching Hospital, Paris, France;Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Service de Médecine Intensive Réanimation, Université de Strasbourg (UNISTRA), Strasbourg, France;UMR 1260, Regenerative Nano Medicine, INSERM, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France;Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Cité et Service d'Anesthésie-Réanimation Médecine Péri Opératoire, Paris, France;Intensive Care Unit, Clermont Tonnerre Military Hospital, Brest, France;Intensive Care Unit, Marie-Curie Teaching Hospital, Université Libre de Bruxelles, Charleroi, Belgium;Medical Intensive Care Unit, Beclère Teaching Hospital, Clamart, France;Medical Intensive Care Unit, Louis Pasteur Hospital, Chartres, France;Medical Intensive Care Unit, Saint Louis Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France;Medical-Surgical Intensive Care Unit, CHU de Limoges, Limoges, France;AfterROSC, Paris, France;Medical-Surgical Intensive Care Unit, Centre Hospitalier Intercommunal André Grégoire, Montreuil, France;Medical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles—Site André Mignot, Le Chesnay, France;Medical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles—Site André Mignot, Le Chesnay, France;AfterROSC, Paris, France;UVSQ, INSERM, CESP, PsyDev Team, Paris-Saclay University, Villejuif, France;Medical-Surgical Intensive Care Unit, Centre Hospitalier du Mans, Le Mans, France;Medical-Surgical Intensive Care Unit, GH Le Havre, Le Havre, France;Medical-Surgical Intensive Care Unit, Saint-Étienne University Hospital, Saint-Étienne, France;Médecine Intensive Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France;Service de Médecine Intensive-Réanimation, CHU Dijon Bourgogne, Dijon, France;

关键词: near-hanging;    intensive care unit;    coma/therapy;    outcome;    cardiopulmonary resuscitation;   

DOI  :  10.3389/fneur.2023.1240383

 received in 2023-06-14, accepted in 2023-08-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis retrospective observational multicentre study in 31 hospitals included consecutive adults admitted after cardiac arrest induced by suicidal hanging. Factors associated with in-hospital mortality were identified by multivariate logistic regression with multiple imputations for missing data and adjusted to the temporal trends over the study period.ResultsOf 450 patients (350 men, median age, 43 [34–52] years), 305 (68%) had a psychiatric history, and 31 (6.9%) attempted hanging while hospitalized. The median time from unhanging to cardiopulmonary resuscitation was 0 [0–5] min, and the median time to return of spontaneous circulation (ROSC) was 20 [10–30] min. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse or unhanging to ROSC>20 min (odds ratio [OR], 4.71; 95% confidence intervals [95%CIs], 2.02–10.96; p = 0.0004); glycaemia >1.4 g/L at admission (OR, 6.38; 95%CI, 2.60–15.66; p < 0.0001); and lactate >3.5 mmol/L at admission (OR, 6.08; 95%CI, 1.71–21.06; p = 0.005). A Glasgow Coma Scale (GCS) score of >5 at admission was associated with lower in-hospital mortality (OR, 0.009; 95%CI, 0.02–0.37; p = 0.0009).ConclusionIn patients with hanging-induced cardiac arrest, time from collapse or unhanging to return of spontaneous circulation, glycaemia, arterial lactate, and coma depth at admission were independently associated with survival to hospital discharge. Knowledge of these risk factors may help guide treatment decisions in these patients at high risk of hospital mortality.

【 授权许可】

Unknown   
Copyright © 2023 Salvetti, Schnell, Pichon, Schenck, Cronier, Perbet, Lascarrou, Guitton, Lesieur, Argaud, Colin, Cholley, Quenot, Merdji, Geeraerts, Piagnerelli, Jacq, Paul, Chelly, de Charentenay, Deye, Danguy des Déserts, Thiery, Simon, Das, Jacobs, Cerf, Mayaux, Beuret, Ouchenir, Lafarge, Sauneuf, Daubin, Cariou, Silva and Legriel.