Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study
BackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis retrospective observational multicentre study in 31 hospitals included consecutive adults admitted after cardiac arre...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1240383/full |
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| author | Marie Salvetti Guillaume Schnell Nicolas Pichon Nicolas Pichon Maleka Schenck Pierrick Cronier Pierrick Cronier Sebastien Perbet Jean-Baptiste Lascarrou Jean-Baptiste Lascarrou Christophe Guitton Olivier Lesieur Olivier Lesieur Laurent Argaud Laurent Argaud Gwenhael Colin Gwenhael Colin Bernard Cholley Jean-Pierre Quenot Hamid Merdji Hamid Merdji Thomas Geeraerts Michael Piagnerelli Gwenaelle Jacq Marine Paul Jonathan Chelly Jonathan Chelly Louise de Charentenay Nicolas Deye Nicolas Deye Nicolas Deye Marc Danguy des Déserts Guillaume Thiery Marc Simon Vincent Das Frederic Jacobs Charles Cerf Julien Mayaux Pascal Beuret Abdelkader Ouchenir Antoine Lafarge Bertrand Sauneuf Bertrand Sauneuf Cedric Daubin Cedric Daubin Alain Cariou Alain Cariou Alain Cariou Stein Silva Stein Silva Stephane Legriel Stephane Legriel Stephane Legriel |
| author_facet | Marie Salvetti Guillaume Schnell Nicolas Pichon Nicolas Pichon Maleka Schenck Pierrick Cronier Pierrick Cronier Sebastien Perbet Jean-Baptiste Lascarrou Jean-Baptiste Lascarrou Christophe Guitton Olivier Lesieur Olivier Lesieur Laurent Argaud Laurent Argaud Gwenhael Colin Gwenhael Colin Bernard Cholley Jean-Pierre Quenot Hamid Merdji Hamid Merdji Thomas Geeraerts Michael Piagnerelli Gwenaelle Jacq Marine Paul Jonathan Chelly Jonathan Chelly Louise de Charentenay Nicolas Deye Nicolas Deye Nicolas Deye Marc Danguy des Déserts Guillaume Thiery Marc Simon Vincent Das Frederic Jacobs Charles Cerf Julien Mayaux Pascal Beuret Abdelkader Ouchenir Antoine Lafarge Bertrand Sauneuf Bertrand Sauneuf Cedric Daubin Cedric Daubin Alain Cariou Alain Cariou Alain Cariou Stein Silva Stein Silva Stephane Legriel Stephane Legriel Stephane Legriel |
| author_sort | Marie Salvetti |
| collection | DOAJ |
| description | BackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis 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 imputations for missing data and adjusted to the temporal trends over the study period.ResultsOf 450 patients (350 men, median age, 43 [34–52] years), 305 (68%) had a psychiatric history, and 31 (6.9%) attempted hanging while hospitalized. The median time from unhanging to cardiopulmonary resuscitation was 0 [0–5] min, and the median time to return of spontaneous circulation (ROSC) was 20 [10–30] min. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse or unhanging to ROSC>20 min (odds ratio [OR], 4.71; 95% confidence intervals [95%CIs], 2.02–10.96; p = 0.0004); glycaemia >1.4 g/L at admission (OR, 6.38; 95%CI, 2.60–15.66; 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 (GCS) score of >5 at admission was associated with lower in-hospital mortality (OR, 0.009; 95%CI, 0.02–0.37; p = 0.0009).ConclusionIn patients with hanging-induced cardiac arrest, time from collapse or 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 of hospital mortality. |
| first_indexed | 2024-03-11T21:57:38Z |
| format | Article |
| id | doaj.art-62806125829a45ca8eedecdfbc2fa2af |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-11T21:57:38Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-62806125829a45ca8eedecdfbc2fa2af2023-09-26T01:42:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-09-011410.3389/fneur.2023.12403831240383Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective studyMarie Salvetti0Guillaume Schnell1Nicolas Pichon2Nicolas Pichon3Maleka Schenck4Pierrick Cronier5Pierrick Cronier6Sebastien Perbet7Jean-Baptiste Lascarrou8Jean-Baptiste Lascarrou9Christophe Guitton10Olivier Lesieur11Olivier Lesieur12Laurent Argaud13Laurent Argaud14Gwenhael Colin15Gwenhael Colin16Bernard Cholley17Jean-Pierre Quenot18Hamid Merdji19Hamid Merdji20Thomas Geeraerts21Michael Piagnerelli22Gwenaelle Jacq23Marine Paul24Jonathan Chelly25Jonathan Chelly26Louise de Charentenay27Nicolas Deye28Nicolas Deye29Nicolas Deye30Marc Danguy des Déserts31Guillaume Thiery32Marc Simon33Vincent Das34Frederic Jacobs35Charles Cerf36Julien Mayaux37Pascal Beuret38Abdelkader Ouchenir39Antoine Lafarge40Bertrand Sauneuf41Bertrand Sauneuf42Cedric Daubin43Cedric Daubin44Alain Cariou45Alain Cariou46Alain Cariou47Stein Silva48Stein Silva49Stephane Legriel50Stephane Legriel51Stephane Legriel52Medical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles—Site André Mignot, Le Chesnay, FranceMedical-Surgical Intensive Care Unit, GH Le Havre, Le Havre, FranceMedical-Surgical Intensive Care Unit, CHU de Limoges, Limoges, FranceAfterROSC, Paris, FranceMédecine Intensive Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, FranceAfterROSC, Paris, FranceIntensive Care Unit, Sud-Francilien Hospital Center, Corbeil-Essonnes, FranceDepartment of Perioperative Medicine, University Hospital of Clermont-Ferrand, 58 Rue Montalembert, Université Clermont Auvergne, CNRS, INSERM, GReD, Clermont-Ferrand, FranceAfterROSC, Paris, FranceMedicine Intensive Reanimation, University Hospital, Nantes, FranceMedical-Surgical Intensive Care Unit, Centre Hospitalier du Mans, Le Mans, FranceAfterROSC, Paris, France0Intensive Care Unit, Saint-Louis Hospital, La Rochelle, FranceAfterROSC, Paris, France1Medical Intensive Care Unit, Hospices Civils de Lyon, Edouard Herriot Teaching Hospital, Lyon, FranceAfterROSC, Paris, France2Medical-Surgical Intensive Care Unit, La Roche-sur-Yon District Hospital Centre, La Roche-sur-Yon, France3Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Cité et Service d'Anesthésie-Réanimation Médecine Péri Opératoire, Paris, France4Service de Médecine Intensive-Réanimation, CHU Dijon Bourgogne, Dijon, France5Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Service de Médecine Intensive Réanimation, Université de Strasbourg (UNISTRA), Strasbourg, France6UMR 1260, Regenerative Nano Medicine, INSERM, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France7Department of Anaesthesiology, Critical Care and Perioperative Medicine, Toulouse University Hospital, Toulouse, France8Intensive Care Unit, Marie-Curie Teaching Hospital, Université Libre de Bruxelles, Charleroi, BelgiumMedical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles—Site André Mignot, Le Chesnay, FranceMedical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles—Site André Mignot, Le Chesnay, FranceAfterROSC, Paris, France9Intensive Care Unit, Groupe Hospitalier Sud Ile de France, Melun, FranceMedical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles—Site André Mignot, Le Chesnay, FranceAfterROSC, Paris, France0Medical Intensive Care Unit, Lariboisière University Hospital, APHP, Paris, France1INSERM UMR-S 942, Lariboisière Hospital, Paris, France2Intensive Care Unit, Clermont Tonnerre Military Hospital, Brest, France3Medical-Surgical Intensive Care Unit, Saint-Étienne University Hospital, Saint-Étienne, France4Department of Intensive Care, Cliniques du Sud-Luxembourg of Arlon, Arlon, Belgium5Medical-Surgical Intensive Care Unit, Centre Hospitalier Intercommunal André Grégoire, Montreuil, France6Medical Intensive Care Unit, Beclère Teaching Hospital, Clamart, France7Department of Intensive Care, Foch Hospital, Suresnes, France8Department of Pulmonology and Intensive Care, Pitié-Salpêtrière Teaching Hospital, Paris, France9Department of Intensive and Continuous Care, Roanne Hospital, Roanne, France0Medical Intensive Care Unit, Louis Pasteur Hospital, Chartres, France1Medical Intensive Care Unit, Saint Louis Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, FranceAfterROSC, Paris, France2General Intensive Care Unit, Cotentin Public Hospital Centre, Cherbourg-en-Cotentin, FranceAfterROSC, Paris, France3Medical Intensive Care Unit, Caen Teaching Hospital, Caen, FranceAfterROSC, Paris, France4Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université de Paris, Paris, France5INSERM U970, Paris Cardiovascular Research Centre, Paris, FranceAfterROSC, Paris, France6Critical Care Unit, University Teaching Hospital of Purpan, Toulouse, FranceMedical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles—Site André Mignot, Le Chesnay, FranceAfterROSC, Paris, France7UVSQ, INSERM, CESP, PsyDev Team, Paris-Saclay University, Villejuif, FranceBackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis 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 imputations for missing data and adjusted to the temporal trends over the study period.ResultsOf 450 patients (350 men, median age, 43 [34–52] years), 305 (68%) had a psychiatric history, and 31 (6.9%) attempted hanging while hospitalized. The median time from unhanging to cardiopulmonary resuscitation was 0 [0–5] min, and the median time to return of spontaneous circulation (ROSC) was 20 [10–30] min. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse or unhanging to ROSC>20 min (odds ratio [OR], 4.71; 95% confidence intervals [95%CIs], 2.02–10.96; p = 0.0004); glycaemia >1.4 g/L at admission (OR, 6.38; 95%CI, 2.60–15.66; 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 (GCS) score of >5 at admission was associated with lower in-hospital mortality (OR, 0.009; 95%CI, 0.02–0.37; p = 0.0009).ConclusionIn patients with hanging-induced cardiac arrest, time from collapse or 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 of hospital mortality.https://www.frontiersin.org/articles/10.3389/fneur.2023.1240383/fullnear-hangingintensive care unitcoma/therapyoutcomecardiopulmonary resuscitation |
| spellingShingle | Marie Salvetti Guillaume Schnell Nicolas Pichon Nicolas Pichon Maleka Schenck Pierrick Cronier Pierrick Cronier Sebastien Perbet Jean-Baptiste Lascarrou Jean-Baptiste Lascarrou Christophe Guitton Olivier Lesieur Olivier Lesieur Laurent Argaud Laurent Argaud Gwenhael Colin Gwenhael Colin Bernard Cholley Jean-Pierre Quenot Hamid Merdji Hamid Merdji Thomas Geeraerts Michael Piagnerelli Gwenaelle Jacq Marine Paul Jonathan Chelly Jonathan Chelly Louise de Charentenay Nicolas Deye Nicolas Deye Nicolas Deye Marc Danguy des Déserts Guillaume Thiery Marc Simon Vincent Das Frederic Jacobs Charles Cerf Julien Mayaux Pascal Beuret Abdelkader Ouchenir Antoine Lafarge Bertrand Sauneuf Bertrand Sauneuf Cedric Daubin Cedric Daubin Alain Cariou Alain Cariou Alain Cariou Stein Silva Stein Silva Stephane Legriel Stephane Legriel Stephane Legriel Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study Frontiers in Neurology near-hanging intensive care unit coma/therapy outcome cardiopulmonary resuscitation |
| title | Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study |
| title_full | Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study |
| title_fullStr | Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study |
| title_full_unstemmed | Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study |
| title_short | Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study |
| title_sort | epidemiology and outcome predictors in 450 patients with hanging induced cardiac arrest a retrospective study |
| topic | near-hanging intensive care unit coma/therapy outcome cardiopulmonary resuscitation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1240383/full |
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