Department of Surgery, Tygerberg Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
S Afr Med J. 2020 Apr 29;110(5):400-402. doi: 10.7196/SAMJ.2020.v110i5.13381.
Hanging is a common form of self-harm, and emergency care physicians will not infrequently be called upon to manage a survivor.Despite the relative frequency of the injury, there is a paucity of literature on the topic and the spectrum and incidence of associated injuries are poorly described.
To review experience with management of victims of hanging at a major trauma centre in South Africa.
All patients treated by the Pietermaritzburg Metropolitan Trauma Service following a hanging incident between December 2012 and December 2018 were identified from the Hybrid Electronic Medical Registry. Basic demographics were recorded, and the management and outcome of each patient were noted.
During the 6-year period under review, a total of 154 patients were seen following a hanging incident. The mean age was 29.4 years. There were 24 females (15.6%) and 130 males (84.4%). The vast majority (n=150; 97.5%) had attempted suicide, and only 4 hangings (2.5%) were accidental. A total of 92 patients (60.9%) had consumed alcohol prior to the incident. There were 23 patients with a Glasgow Coma Score (GCS) <9 (severe traumatic brain injury (TBI)), 14 with a GCS of 9 - 12 (moderate TBI) and 117 with a GCS >12 (mild TBI). A total of 7 patients (4.5%) required intensive care unit admission, and 25 (16.2%) required intubation. The following extracranial injuries were documented on computed tomography scans: hyoid bone fractures (n=2), cervical spine fracture (n=10), mandible fracture (n=4) and oesophageal injury (n=1). Intracranial pathology was evident on 27.0% of scans, with the most common finding being global cerebral ischaemia. The mortality rate was 2.5% (4/154).
Hanging is a common mechanism of self-harm. It is associated with significant injuries and mortality. The acute management of hanging should focus on airway protection followed by detailed imaging of the head and neck. Further work must attempt to include mortuary data on hanging.
上吊是一种常见的自残形式，急诊医生经常需要处理幸存者。尽管这种伤害相对常见，但相关文献却很少，其损伤谱和发生率描述得也很差。
回顾南非一家大型创伤中心处理上吊者的经验。
从混合电子医疗登记处确定 2012 年 12 月至 2018 年 12 月期间因上吊事件接受皮埃特马里茨堡大都市创伤服务治疗的所有患者。记录基本人口统计学数据，并注意每位患者的治疗和结果。
在审查的 6 年期间，共有 154 名患者因上吊事件就诊。平均年龄为 29.4 岁。其中女性 24 例（15.6%），男性 130 例（84.4%）。绝大多数（n=150；97.5%）试图自杀，仅有 4 例上吊（2.5%）是意外。共有 92 名患者（60.9%）在事件发生前饮酒。格拉斯哥昏迷评分（GCS）<9 的患者有 23 例（严重创伤性脑损伤（TBI）），GCS 为 9-12 的患者有 14 例（中度 TBI），GCS >12 的患者有 117 例（轻度 TBI）。需要入住重症监护病房的患者有 7 例（4.5%），需要插管的患者有 25 例（16.2%）。在计算机断层扫描上记录到以下颅外损伤：舌骨骨折（n=2）、颈椎骨折（n=10）、下颌骨骨折（n=4）和食管损伤（n=1）。27.0%的扫描显示颅内有病变，最常见的发现是全脑缺血。死亡率为 2.5%（4/154）。
上吊是一种常见的自残方式。它与严重的伤害和死亡率有关。上吊的急性处理应侧重于气道保护，然后对头颈进行详细成像。进一步的工作必须尝试包括太平间数据。
