SESSION TITLE: Critical Care Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Assess the case rate of Acute Respiratory Distress Syndrome (ARDS) in near hanging, neurologic outcomes and mortality after near-hanging; and evaluate clinical characteristics associated with these outcomes.
METHODS: Single-center, state-wide retrospective, observational study of consecutive patients admitted between August 2002 and September 2011 with a primary diagnosis of “hanging injury”.
RESULTS: Of 56 patients, 73% (41/56) were male. The median age was 31 (IQR: 16-56). Upon arrival, 9% (5/56) did not have a pulse, and 23% (13/56) patients were intubated, either in the field or in the trauma resuscitation unit. The median Glasgow Coma Scale (GCS) was 13 (IQR: 3-15); 14% (8/56) had a GCS=3. ARDS developed in 9% (5/56) of patients. Traumatic anoxic brain injury resulted in 9% (5/56) of patients with case fatality of 5% (3/56). Lower median GCS [3 (IQR: 3-7) vs. 14 (IQR: 3-15), p=0.0003] and intubation in field or in trauma resuscitation unit [100% (5/5) vs. 16% (8/51), p=0.0003] were associated with the development of ARDS. Risk factors of death were GCS=3 [100% (3/3) vs. 9% (5/53), p=0.002]; pulselessness upon arrival of EMS [100% (3/3) vs. 4% (2/53), p<0.001]; and abnormal neurologic imaging [50% (1/2) vs. zero, p=0.04].
CONCLUSIONS: The ARDS case rate after near-hanging is similar to the general trauma population. Low GCS and intubation are associated with increased risk of ARDS and death.
CLINICAL IMPLICATIONS: Near-hanging patients are at risk for ARDS. Low GCS and intubation identify patients at high risk for poor outcomes.
DISCLOSURE: The following authors have nothing to disclose: Sahar Mansoor, Majid Afshar, Matthew Barrett, Gordon Smith, Erik Barr, Matthew Lissauer, Giora Netzer
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