Department of Emergency and Critical Care Medicine, NHO Tokyo Medical Center, Tokyo, Japan.
Department of Emergency and Critical Care Medicine, NHO Tokyo Medical Center, Tokyo, Japan.
Am J Emerg Med. 2024 Oct;84:45-49. doi: 10.1016/j.ajem.2024.07.047. Epub 2024 Jul 28.
Cervical injuries are important complications of near-hanging, which is defined as self-injury by hanging if the patient survives at admission. Previous studies have reported that complicated cervical injuries due to near-hanging are uncommon. The primary aim of this study was to evaluate whether cervical imaging can be safely omitted for near-hanging patients who are alert and have no abnormal neck symptoms or signs.
This was a retrospective observational study to investigate the prevalence of cervical injuries among hospitalized near-hanging patients between April 2014 and June 2023. The primary outcome was the prevalence of any complicated cervical injuries, which included laryngeal fractures, laryngeal deviations, spinal cord injuries, cervical spine fractures, and blunt cerebrovascular injuries. The primary aim of this study was to determine the primary outcome among near-hanging patients with normal levels of consciousness and no abnormal neck symptoms or signs.
During the study period, a total of 63 near-hanging patients were hospitalized. Of these, 11 patients (18%) with normal levels of consciousness and no neck symptoms or signs at admission were included. The median age of the patients was 37 years (IQR 27 to 53); 5 (45%) were women, and none had cardiac arrest at the scene. For the primary outcome, no complicated cervical injuries (0%; 95% CI, 0% to 27%) occurred among the small number of near-hanging patients who had normal levels of consciousness and no abnormal neck symptoms or signs at admission.
There were no cases of complicated cervical injuries among near-hanging patients with normal levels of consciousness and no abnormal neck symptoms or signs. Further prospective multicenter studies are warranted to investigate whether cervical imaging can be safely omitted in assessments of these patients.
颈椎损伤是近乎自缢的重要并发症，自缢定义为入院时存活的患者自我伤害。既往研究报道，近乎自缢导致的复杂颈椎损伤并不常见。本研究的主要目的是评估意识清醒且无异常颈部症状或体征的近乎自缢患者是否可以安全地省略颈椎影像学检查。
这是一项回顾性观察性研究，旨在调查 2014 年 4 月至 2023 年 6 月期间住院的近乎自缢患者中颈椎损伤的患病率。主要结局是任何复杂颈椎损伤的患病率，包括喉骨折、喉偏斜、脊髓损伤、颈椎骨折和钝性脑血管损伤。本研究的主要目的是确定意识水平正常且无异常颈部症状或体征的近乎自缢患者的主要结局。
在研究期间，共收治 63 例近乎自缢患者，其中 11 例（18%）入院时意识水平正常且无颈部症状或体征。患者的中位年龄为 37 岁（IQR 27 至 53）；5 例（45%）为女性，现场均无心脏骤停。主要结局方面，在意识水平正常且入院时无异常颈部症状或体征的少数近乎自缢患者中，无复杂颈椎损伤（0%；95%CI，0%至 27%）发生。
意识水平正常且无异常颈部症状或体征的近乎自缢患者中无复杂颈椎损伤。需要进一步开展多中心前瞻性研究，以调查这些患者的评估是否可以安全地省略颈椎影像学检查。
