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Critical Care |

Acute Respiratory Distress Syndrome and Outcomes After Near-Hanging

Sahar Mansoor, MD; Majid Afshar, MD; Matthew Barrett, DO; Gordon Smith, MBChB; Erik Barr, BA; Matthew Lissauer, MD; Giora Netzer, MD
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Department of Medicine, University of Maryland School of Medicine, Baltimore, MD


Chest. 2013;144(4_MeetingAbstracts):377A. doi:10.1378/chest.1703978
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Abstract

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

No Product/Research Disclosure Information


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