Spirek Benton, Winborne Ashley, Plain Margaret, Glass George, Brady William
University of Virginia School of Medicine, Charlottesville, VA, USA.
University of Virginia College of Arts and Sciences, Charlottesville, VA, USA.
Turk J Emerg Med. 2025 Oct 1;25(4):256-264. doi: 10.4103/tjem.tjem_247_24. eCollection 2025 Oct-Dec.
Non-judicial hanging events presenting to emergency healthcare providers exhibit a wide range of severity, from cardiac arrest to minor soft tissue neck contusions, making it essential for providers to anticipate potential injuries. This review investigated the frequency of musculoskeletal, neurologic, airway, and vascular injuries to neck structures following such events. A narrative review of the PubMed database was conducted, selecting hypothesis-testing articles based on criteria including non-judicial hanging, emergency department evaluation, and consideration of at least one of the four injury areas. Two reviewers selected the final articles, analyzed the data, and investigated three questions focusing on the frequency of these injury types. The reference lists of the selected articles were also reviewed for additional relevant studies. The analysis included 30 articles (3809 patients) for musculoskeletal and neurologic injuries, 20 articles (2047 patients) for airway injuries, and 13 articles (2717 patients) for vascular injuries. The overall injury rates in the neck region among the study population were musculoskeletal 3.0%, neurologic 0.5%, airway 5.2%, and vascular 2.5%. In conclusion, among patients surviving to emergency department arrival after a non-judicial hanging event, the rates of injury to neck structures are low, with airway injuries being the most frequent at approximately 5% of cases. Injuries were observed to be more common in adults compared to pediatric patients, and the medical significance of these injuries varied considerably. Further research is necessary to more comprehensively define the expected pathologies associated with this patient presentation and to guide the most appropriate evaluation strategies.
因非司法绞缢事件而被送往急救医护人员处的患者，其严重程度范围广泛，从心脏骤停到颈部软组织轻度挫伤不等，这使得医护人员必须预估可能出现的损伤。本综述调查了此类事件后颈部结构的肌肉骨骼、神经、气道和血管损伤的发生率。对PubMed数据库进行了叙述性综述，根据包括非司法绞缢、急诊科评估以及考虑四个损伤区域中至少一个区域等标准选择假设检验文章。两名评审员挑选了最终文章，分析数据，并研究了三个聚焦于这些损伤类型发生率的问题。还对所选文章的参考文献列表进行了审查，以查找其他相关研究。分析纳入了30篇关于肌肉骨骼和神经损伤的文章（3809例患者）、20篇关于气道损伤的文章（2047例患者）以及13篇关于血管损伤的文章（2717例患者）。研究人群中颈部区域的总体损伤率为：肌肉骨骼损伤3.0%、神经损伤0.5%、气道损伤5.2%、血管损伤2.5%。总之，在非司法绞缢事件后存活至抵达急诊科的患者中，颈部结构的损伤率较低，气道损伤最为常见，约占病例的5%。与儿科患者相比，成人的损伤更为常见，且这些损伤的医学意义差异很大。有必要进行进一步研究，以更全面地界定与此类患者表现相关的预期病理情况，并指导最合适的评估策略。
