Cardiac arrest after hanging: A scoping review

Area of Science:

• Emergency Medicine
• Cardiology
• Toxicology

Background:

• Hanging is a frequent cause of suicide and asphyxial cardiac arrest.
• Limited data exist regarding the optimal treatment for cardiac arrest following hanging.
• This scoping review examines interventions and outcomes for patients with and without cardiac arrest after hanging.

Approach:

• A comprehensive literature search was conducted across Medline, Embase, and Cochrane databases up to May 12, 2024.
• Articles were included if they focused on non-judicial hanging in adults or children, involved cardiac arrest, and reported functional or survival outcomes.
• Forty-five observational studies, primarily from high-income countries, were included after screening 855 articles.

Key Points:

• Survival with favorable functional outcomes was uncommon in patients experiencing cardiac arrest post-hanging.
• Conversely, patients without cardiac arrest after hanging demonstrated a high rate of survival with good function.
• Injuries to the cervical spine, airway, and vasculature were infrequently reported.
• No interventions were identified that demonstrably improved survival after return of spontaneous circulation.

Conclusions:

• There is a significant paucity of data to guide the treatment of cardiac arrest subsequent to hanging.
• Cardiac arrest emerges as a crucial determinant of adverse outcomes in hanging incidents.
• Future research should standardize the reporting of outcomes for cardiac arrest patients following hanging, adhering to the Utstein template.