481 - PROGNOSTIC FACTORS FOLLOWING NEAR-HANGING IN CHILDREN
‘Near-hanging’ describes survival following a hanging incident; eventual outcome includes death or neuro-disability.
Examine mechanism, organ dysfunction, management, and associations with outcome, for admissions to our PICU following near-hanging.
Retrospectively identify all PICU admissions 2008-2018, gather routinely collected clinical data. Two tailed Fischer’s exact test and unpaired T-test performed.
·15 patients (11 months – 16 years, 11/15 male)
·8 suicide attempts, 7 accidental.
·7 children had good outcome (GCS 15 on discharge from PICU).
·8 children had poor outcome – 6 died, 2 neurological impairment.
·Poor outcome was significantly associated with cardiac arrest, pulmonary oedema, and abnormal LFTs.
·Three children with good outcome had a worst recorded GCS of 3.
Near-hanging is a rare cause of PICU admission. Multiple organ dysfunction is common, as is death and disability. Cardiac arrest had universally poor outcome, as per previous studies.
Pulmonary oedema and abnormal LFTs were also significantly associated with poor outcome, a new finding, though sample size is small.
This supports previous work, and suggests multiple organ failure heralds a poor prognosis.
Thanks to Dr Stuart Hartshorn and Dr Kevin Morris for their support.
References: van Hasselt TJ, Hartshorn S. Hanging and near hanging in children: injury patterns and a clinical approach to early management. Archives of Disease in Childhood - Education and Practice Published Online First:09 July 2018. doi: 10.1136/archdischild-2018-314773