TY  - JOUR
PY  - 2019//
TI  - Near-hangings: epidemiology, injuries, and investigations
JO  - Journal of trauma and acute care surgery
A1  - Schellenberg, Morgan
A1  - Inaba, Kenji
A1  - Warriner, Zachary
A1  - Alfson, Daniel
A1  - Roman, Jordan
A1  - Van Velsen, Valery
A1  - Lam, Lydia
A1  - Demetriades, Demetrios
SP  - 454
EP  - 457
VL  - 86
IS  - 3
N2  - BACKGROUND: Near-hangings are an infrequent cause of trauma and the optimal work-up for these patients is unclear. The study objectives were to define the epidemiology, injury patterns, and use of investigations, including CTA neck, after near-hangings. <br><br>METHODS: All patients presenting to LAC+USC Medical Center (2008-2015) after near-hanging (ICD-9 E913.8, E953.0, E963, or E983.0) were screened for inclusion. Transferred patients were excluded. Patient demographics, clinical data, injury data, investigations performed, and outcomes were collected. <br><br>RESULTS: Over the study period, 71 patients were identified. Mean age was 37 (range 17-89) and 85% (n=64) were male. Average GCS was 10 (range 3-15) and mean ISS was 5 (range 1-35). Mortality rate was 14% (n=10). The most common finding on physical examination was a ligature mark (n=38, 54%). Cervical injuries after near-hangings occurred infrequently (5 injuries in 4 patients [6%]: 3 [4%] arterial injuries and 2 [3%] laryngotracheal injuries). Only one patient (1%) required surgical and/or endovascular intervention. Two (3%) arrived in cardiac arrest, underwent resuscitative thoracotomy, and were pronounced dead. All others (n=69, 97%) underwent CTA of the neck. No patient in this series manifested signs or symptoms of cervical injury during hospitalization after a normal CTA neck on presentation. <br><br>CONCLUSIONS: Near-hangings infrequently result in cervical injury and intervention is rarely needed. When injuries are sustained, they occur to critical structures such as the larynx, trachea, and cervical vasculature. Therefore, effective injury screening is important. We recommend CTA of the neck as the optimal initial imaging investigation after near-hangings. LEVEL OF EVIDENCE: IV: Study Type: Descriptive case series.<p />  <p>Language: en</p>
LA  - en
SN  - 2163-0755
UR  - http://dx.doi.org/10.1097/TA.0000000000002134
ID  - ref1
ER  -