[Patients admitted to a medical intensive care unit following attempted hanging, 2010–21]

Hanging is one of the most common causes of death among young adults in Norway. Our aim was to study the hospital course and cerebral function on discharge in patients admitted to our Medical Intensive Care Unit after hanging without skeletal injury.

Retrospective study based on the medical records of patients admitted to the Medical Intensive Care Unit at Oslo University Hospital (OUS), Ullevål after hanging, from January 2010 to December 2021. Cerebral function on discharge was classified according to Cerebral Performance Category (CPC) from grade 1 (normal cerebral function) to 5 (brain death).

135 patients were admitted to OUS after hanging during the period; 60 of these were admitted to the Medical Intensive Care Unit and were included in this study. There were 35 men and 25 women. Mental illness was documented in the medical records of 43 patients, somatic illness in 24, previous substance abuse in 19, and previous suicide attempts in 19. Upon admission, 34 patients had suffered cardiac arrest, and 39 had a Glasgow Coma Scale (GCS) score of 3. The most common complication was pneumonia (n=42). Twenty-seven patients (45%) died, all with a GCS score of 3 on admission, of which 25 had pre-hospital cardiac arrest. Ten became organ donors. Among the 33 survivors, 28 had a CPC score of 1 and five had a CPC score of 2 on discharge. The median lactate concentration at admission was 8.1 mmol/L among those who died versus 3.8 mmol/L among survivors.

Hanging has a high mortality rate. Cardiac arrest, a GCS score of 3, and lactic acidosis were more common among those who died than among the survivors. The organ donation rate was high, and most survivors had a good cerebral function, assessed by CPC score.