The Characteristics of Patients with Hanging Injury and the Usefulness of S100B Protein as a Predictive Factor According to the Presence of Cardiac Arrest

ABSTRACT

PURPOSE: Brain injury due to hanging leads has a high mortality rate and severe neurological sequelae. Serum S100B for predicting brain injury in hanging injury has not been evaluated. The aim of this study is to review the characteristics and the prognosis of hanging patients and to determine the usefulness of S100B as a predicting factor. METHODS: A single center, retrospective study was conducted from January 2011 to December 2014. A total of 102 patients visited the emergency department (ED) with hanging injuries and 70 resuscitated patients were enrolled. RESULTS: Of all patients, 56 (54.9%) patients were male and 96 (94.1%) patients committed suicide by hanging; 61 (59.8%) patients visited the ED with cardiac arrest. In arrest patients, all survived patients showed a Cerebral Performance Category (CPC) score of 4. Although 16 (39.0%) had the initial mental status as stupor or coma in non-arrest patients, 1 (2.4%) remained as CPC 4. Among the resuscitated patients, comatose mental status, absence of pupil light reflex (PLR), and diffuse swelling on brain computed tomography (CT) tended to show relation to high mortality rate. Only PLR tended to show relation to CPC score in non-arrest patients. The elevated level of serum S100B was related to the mortality in arrest patients, whereas it was not related to CPC score in non-arrest patients. CONCLUSION: The prognosis of hanging patients was related to PLR irrespective of the presence of cardiac arrest. The serum S100B level for prediction of prognosis is not sufficient in non-arrest patients with hanging.