AUTHOR=Salvetti Marie , Schnell Guillaume , Pichon Nicolas , Schenck Maleka , Cronier Pierrick , Perbet Sebastien , Lascarrou Jean-Baptiste , Guitton Christophe , Lesieur Olivier , Argaud Laurent , Colin Gwenhael , Cholley Bernard , Quenot Jean-Pierre , Merdji Hamid , Geeraerts Thomas , Piagnerelli Michael , Jacq Gwenaelle , Paul Marine , Chelly Jonathan , de Charentenay Louise , Deye Nicolas , Danguy des Déserts Marc , Thiery Guillaume , Simon Marc , Das Vincent , Jacobs Frederic , Cerf Charles , Mayaux Julien , Beuret Pascal , Ouchenir Abdelkader , Lafarge Antoine , Sauneuf Bertrand , Daubin Cedric , Cariou Alain , Silva Stein , Legriel Stephane 

TITLE=Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1240383

DOI=10.3389/fneur.2023.1240383

ISSN=1664-2295

ABSTRACT=Background. Cardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.Methods. This retrospective observational multicentre study in 31 hospitals included consecutive adults admitted after cardiac arrest induced by suicidal hanging. Factors associated with in-hospital mortality were identified by multivariate logistic regression with multiple imputation for missing data and adjusted to time of management over the study period.Results. Of 450 patients (350 men, median age, 43 [34-52] years), 305 (68%) had a psychiatric history and 31 (6.9%) attempted hanging while hospitalised. Median time from unhanging to cardiopulmonary resuscitation was 0 [0-5] minutes and median time to return of spontaneous circulation (ROSC) was 20 [10-30] minutes. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse/unhanging to ROSC>20 min (odds ratio [OR], 4.71; 95% confidence interval [95%CI], 2.02-10.96; p=0.0004), glycaemia >1.4 g/L at admission (OR, 6.38; 95%CI, p<0.0001), and lactate >3.5 mmol/L at admission (OR, 6.08; 95%CI, 1.71-21.06; p=0.005). A Glasgow Coma Scale score >5 at admission was associated lower in-hospital mortality (OR, 0.009; 95%CI, 0.02-0.37; p=0.0009).In patients with hanging-induced cardiac arrest, time from collapse/unhanging to return of spontaneous circulation, glycaemia, arterial lactate, and coma depth at admission were independently associated with survival to hospital discharge. Knowledge of these risk factors may help guide treatment decisions in these patients at high risk for hospital mortality. Clinical Trials.gov registration #NCT04096976.