Renuka M K, Kalaiselvan M S, Arunkumar A S
Department of Anaesthesiology, Sri Ramachandra University, Chennai, Tamil Nadu, India.
Department of Critical Care Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India.
Indian J Anaesth. 2017 Jul;61(7):538-542. doi: 10.4103/ija.IJA_170_17.
Hanging is a frequently used method to attempt suicide in India. There is a lack of data in the Indian population regarding clinical features and outcomes of suicidal hanging. The purpose of this study was to evaluate the factors affecting mortality and morbidity in patients admitted with suicidal hanging to the Intensive Care Unit (ICU).
A 6-year retrospective study of adult patients admitted to the ICU with suicidal hanging was analysed for demographics, mode of hanging, lead time to emergency room (ER) admission, clinical presentation, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, admission Glasgow coma scale (GCS) and neurological outcomes. The primary outcome was in-hospital mortality rate. Secondary outcomes were hospital length of stay (LOS), ICU-LOS, time for neurological recovery, organ support and duration of mechanical ventilation. Statistical analysis was performed using the Student's -test for continuous variables and Chi-square test for categorical variables.
We analysed data of 106 patients. The median age was 27 years [Interquartile Range (IQR) (22-34)]. The median lead time to ER admission was 1 h [IQR (0.5-1.4)] with median ICU stay of 3 days [IQR (2-4)]. Vasopressors were administered to 27.4% patients. GCS was ≤7 in 65% patients, and 84.9% patients received mechanical ventilation. Mortality rate was 10.3%. Survivors recovered with normal organ function.
Suicidal hanging is associated with significant mortality. Admission GCS, APACHE II and 48 h SOFA score were predictors of poor outcome.
在印度，上吊是一种常用的自杀方式。印度人群中缺乏关于自杀性上吊的临床特征和结局的数据。本研究的目的是评估入住重症监护病房（ICU）的自杀性上吊患者的死亡率和发病率相关因素。
对入住ICU的成年自杀性上吊患者进行了一项为期6年的回顾性研究，分析了人口统计学、上吊方式、急诊室（ER）入院的间隔时间、临床表现、急性生理与慢性健康状况评估II（APACHE II）和序贯器官衰竭评估（SOFA）评分、入院时格拉斯哥昏迷量表（GCS）以及神经学结局。主要结局是住院死亡率。次要结局包括住院时间（LOS）、ICU住院时间、神经功能恢复时间、器官支持情况以及机械通气时间。对连续变量采用学生t检验进行统计分析，对分类变量采用卡方检验。
我们分析了106例患者的数据。中位年龄为27岁[四分位间距（IQR）（22 - 34）]。急诊室入院的中位间隔时间为1小时[IQR（0.5 - 1.4）]，ICU中位住院时间为3天[IQR（2 - 4）]。27.4%的患者使用了血管升压药。65%的患者GCS≤7，84.9%的患者接受了机械通气。死亡率为10.3%。幸存者器官功能恢复正常。
自杀性上吊与显著的死亡率相关。入院时的GCS、APACHE II和48小时SOFA评分是不良结局的预测指标。
