Near hanging: Profile, emergency management, and outcome

Abstract

Background: Hanging is a very common mode of deliberate self-harm (DSH) used by patients. The spectrum of the triggers and methods used vary from play to place. Objective: To study the profile and outcome of near hanging. Methods and Materials: A retrospective descriptive study was conducted on patients presenting with near hanging to the Emergency Department (ED) between January 2017 and December 2018. Data were obtained from the triage registry of the ED. Results: During the study period, 1821 presented with DSH with 144 cases of near hanging. The mean age (SD) was 33 (12.9) years and the sex distribution was equal. One-tenth (9.7%) of them had a known psychiatric illness, whereas a quarter of them (22.9%) were under the influence of alcohol at the time of the incident. The most common material used was saree (52.8%). Eight patients were intubated elsewhere and referred to ED, whereas 79% required emergency intubation in ED, with the majority being hypoxic at arrival (84.7%). Of the 144 patients, 58.4% were admitted to the hospital, whereas 20.8% were discharged stable after 24 hours of observation. Among in-patients, the majority (92.7%) were discharged stable, 4.8% left against medical advice, and 2.3% died in the hospital. Conclusions: Hanging as a method of self-harm is used by a tenth of patients who present to the ED with DSH. Saree and rope are the most common materials used for this act. One-fifth of our patients had a bad outcome that was independent of most underlying baseline factors.