Sun Hanqing, Hotvedt Cecilie, Jacobsen Dag
Institutt for klinisk medisin, Universitetet i Oslo, og, Ortopedisk avdeling, Molde Sjukehus.
Akuttmedisinsk avdeling, Medisinsk klinikk, Oslo universitetssykehus, Ullevål.
Tidsskr Nor Laegeforen. 2024 Sep 10;144(11). doi: 10.4045/tidsskr.23.0796. Print 2024 Sep 24.
Hanging is one of the most common causes of death among young adults in Norway. Our aim was to study the hospital course and cerebral function on discharge in patients admitted to our Medical Intensive Care Unit after hanging without skeletal injury.
Retrospective study based on the medical records of patients admitted to the Medical Intensive Care Unit at Oslo University Hospital (OUS), Ullevål after hanging, from January 2010 to December 2021. Cerebral function on discharge was classified according to Cerebral Performance Category (CPC) from grade 1 (normal cerebral function) to 5 (brain death).
135 patients were admitted to OUS after hanging during the period; 60 of these were admitted to the Medical Intensive Care Unit and were included in this study. There were 35 men and 25 women. Mental illness was documented in the medical records of 43 patients, somatic illness in 24, previous substance abuse in 19, and previous suicide attempts in 19. Upon admission, 34 patients had suffered cardiac arrest, and 39 had a Glasgow Coma Scale (GCS) score of 3. The most common complication was pneumonia (n=42). Twenty-seven patients (45%) died, all with a GCS score of 3 on admission, of which 25 had pre-hospital cardiac arrest. Ten became organ donors. Among the 33 survivors, 28 had a CPC score of 1 and five had a CPC score of 2 on discharge. The median lactate concentration at admission was 8.1 mmol/L among those who died versus 3.8 mmol/L among survivors.
Hanging has a high mortality rate. Cardiac arrest, a GCS score of 3, and lactic acidosis were more common among those who died than among the survivors. The organ donation rate was high, and most survivors had a good cerebral function, assessed by CPC score.
在挪威，缢死是青年成年人中最常见的死亡原因之一。我们的目的是研究在无骨骼损伤的缢伤后入住我院医学重症监护病房的患者的住院病程及出院时的脑功能。
基于2010年1月至2021年12月在奥斯陆大学医院（OUS）乌勒瓦尔分院缢伤后入住医学重症监护病房的患者的病历进行回顾性研究。出院时的脑功能根据脑功能分级（CPC）从1级（正常脑功能）到5级（脑死亡）进行分类。
在此期间，有135例患者在缢伤后入住OUS；其中60例入住医学重症监护病房并纳入本研究。男性35例，女性25例。43例患者的病历中有精神疾病记录，24例有躯体疾病记录，19例有既往药物滥用史，19例有既往自杀未遂史。入院时，34例患者发生心脏骤停，39例格拉斯哥昏迷量表（GCS）评分为3分。最常见的并发症是肺炎（n = 42）。27例患者（45%）死亡，所有患者入院时GCS评分为3分，其中25例有院前心脏骤停。10例成为器官捐献者。在33例幸存者中，28例出院时CPC评分为1分，5例为2分。死亡患者入院时乳酸浓度中位数为8.1 mmol/L，而幸存者为3.8 mmol/L。
缢死死亡率高。心脏骤停、GCS评分为3分和乳酸酸中毒在死亡患者中比幸存者中更常见。器官捐献率高，且根据CPC评分评估，大多数幸存者脑功能良好。
