Acute respiratory distress syndrome and outcomes after near hanging Journal Article

Authors: Mansoor, S.; Afshar, M; Barrett, M.; Smith, G. S.; Barr, E. A.; Lissauer, M. E.; McCurdy, M. T.; Murthi, S. B.; Netzer, G
Article Title: Acute respiratory distress syndrome and outcomes after near hanging
Abstract: PURPOSE: The purpose of this study is to assess the case rate of acute respiratory distress syndrome (ARDS) after near hanging and the secondary outcomes of traumatic and/or anoxic brain injury and death. Risk factors for the outcomes were assessed. METHOD: The method is a single-center, statewide retrospective cohort study of consecutive patients admitted between August 2002 and September 2011, with a primary diagnosis of nonjudicial "hanging injury." RESULTS: Of 56 patients, 73% were male. The median age was 31 (Interquartile range (IQR), 16-56). Upon arrival, 9% (5/56) did not have a pulse, and 23% (13/56) patients were intubated. The median Glasgow Coma Scale (GCS) was 13 (IQR, 3-15); 14% (8/56) had a GCS = 3. Acute respiratory distress syndrome developed in 9% (5/56) of patients. Traumatic anoxic brain injury resulted in 9% (5/56) of patients. The in-hospital case fatality was 5% (3/56). Lower median GCS (3 [IQR, 3-7] vs 14 [IQR, 3-15]; P = .0003) and intubation in field or in trauma resuscitation unit (100% [5/5] vs 16% [8/51]; P = .0003) were associated with ARDS development. Risk factors of death were GCS = 3 (100% [3/3] vs 9% [5/53]; P = .002), pulselessness upon arrival of emergency medical services (100% [3/3] vs 4% [2/53]; P .001], and abnormal neurologic imaging (50% [1/2] vs zero; P = .04). CONCLUSIONS: The ARDS case rate after near hanging is similar to the general trauma population. Low GCS and intubation are associated with increased risk of ARDS development. The rate of traumatic and/or anoxic brain injury in this population is low.
Journal Title: The American Journal of Emergency Medicine
Volume: 33
Issue: 3
ISSN: 1532-8171; 0735-6757
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2015
Start Page: 359
End Page: 362
Language: eng
Notes: LR: 20150405; CI: Copyright (c) 2014; GR: 1R01AA018313-01A1/AA/NIAAA NIH HHS/United States; GR: F32 AA022553/AA/NIAAA NIH HHS/United States; GR: F32AA022553-01/AA/NIAAA NIH HHS/United States; GR: R01 AA018313/AA/NIAAA NIH HHS/United States; JID: 8309942; NIHMS656190; OID: NLM: NIHMS656190 [Available on 03/01/16]; OID: NLM: PMC4385476 [Available on 03/01/16]; PMCR: 2016/03/01 00:00; 2014/07/20 [received]; 2014/10/31 [revised]; 2014/12/03 [accepted]; 2014/12/09 [aheadofprint]; ppublish