Near-hanging as presenting to hospitals in Queensland: Recommendations for practice

Boots, R. J., Joyce, C., Mullany, D. V., Anstey, C., Blackwell, N., Garrett, P. M., Gillis, S. and Alexander, N. (2006) Near-hanging as presenting to hospitals in Queensland: Recommendations for practice. Anaesthesia and Intensive Care, 34 6: 736-745.

Author Boots, R. J.
Joyce, C.
Mullany, D. V.
Anstey, C.
Blackwell, N.
Garrett, P. M.
Gillis, S.
Alexander, N.
Title Near-hanging as presenting to hospitals in Queensland: Recommendations for practice
Journal name Anaesthesia and Intensive Care   Check publisher's open access policy
ISSN 0310-057X
Publication date 2006
Sub-type Article (original research)
Volume 34
Issue 6
Start page 736
End page 745
Total pages 10
Place of publication Edgecliff, NSW, Australia
Publisher Australian Society of Anaesthetists
Collection year 2006
Language eng
Subject C1
321202 Epidemiology
730211 Mental health
Abstract Near-hanging is an increasing presentation to hospitals in Australasia. We reviewed the clinical management and outcome of these patients as they presented to public hospitals in Queensland. A retrospective clinical record audit was made at five public hospitals between 1991 and 2000. Of 161 patients enrolled, 82% were male, 8% were Indigenous and 10% had made a previous hanging attempt. Chronic medical illnesses were documented in 11% and previous psychiatric disorders in 42%. Of the 38 patients with a Glasgow Coma Scale score (GCS) of 3 on arrival at hospital, 32% returned to independent living and 63% died. Fifty two patients received CPR, of whom 46% had an independent functional outcome. Independent predictors of mortality were a GCS on hospital arrival of 3 (AOR 150, CI 95% 12.4-1818, P<0.001), taking plain X-rays of the cervical spine (AOR 0.06, CI 95% 0.004-0.97, P=0.047) and contact with the ground (AOR 0.03, CI 95% 0.002-0.62, P=0.02). Only 66% had imaging of the cervical spine performed with other imaging performed infrequently. There were three laryngeal, two hyoid bone and three cervical spine injuries and one carotid dissection. The number of cervical spine X-rays required to find a significant cervical spine fracture was 54. Near-hanging presenting to hospital with a poor conscious state or even cardiac arrest can have a favourable clinical outcome. Radiological investigations are infrequently performed despite a low GCS precluding early accurate assessment. Given the general favourable outcome, an aggressive approach to searching for correctable injuries is recommended. (author abstract)
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2007 Higher Education Research Data Collection
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Created: Wed, 15 Aug 2007, 10:23:13 EST