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Injury patterns and mortality associated with near-hanging in children.
- Source :
-
The American journal of emergency medicine [Am J Emerg Med] 2024 Jan; Vol. 75, pp. 83-86. Date of Electronic Publication: 2023 Oct 26. - Publication Year :
- 2024
-
Abstract
- Background: The pathophysiology of near-hanging in children is different from that of adults due to anatomic, physiologic, and injury-related mechanisms, with evidence suggesting that blunt cerebrovascular injuries (BCVI) and cervical spine injuries (CSI) are uncommon. We sought to estimate the incidence of secondary injuries and their association with mortality in pediatric near-hanging victims.<br />Methods: We performed a retrospective observational study of children (≤17 years) with a diagnosis code for hanging between October 1, 2015 and February 28, 2023 who presented to one of 47 geographically diverse US children's hospitals. We evaluated the incidence of the following secondary injuries: cerebral edema, pneumothorax, pulmonary edema, BCVI, and CSI. We performed Fisher's exact test with Bonferroni correction to identify associations between intentionality, sex, age, and secondary injuries with mortality.<br />Results: We included 1929 children, of whom 33.8% underwent neuroimaging, 45.9% underwent neck imaging, and 38.7% underwent neck angiography. The most common injury was cerebral edema (24.0%), followed by pulmonary edema (3.2%) and pneumothorax (2.8%). CSI (2.1%) and BCVI (0.9%) occurred infrequently. Cerebral edema, pneumothorax, pulmonary edema, and younger age (≤12 years) were associated with mortality.<br />Conclusions: In this multi-center study of pediatric near-hanging victims, BCVI and CSI occurred rarely and were not associated with mortality. While children in our study underwent neck imaging more frequently than head imaging, cerebral edema occurred more often than other injury types and imparted the highest mortality risk. Given the rarity of BCVI and CSI, a selective approach to neck imaging may be warranted in pediatric near-hanging events.<br />Competing Interests: Declaration of Competing Interest No authors have conflicts of interest to disclose.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Humans
Child
Retrospective Studies
Brain Edema diagnostic imaging
Brain Edema epidemiology
Brain Edema etiology
Pneumothorax etiology
Pneumothorax complications
Pulmonary Edema complications
Wounds, Nonpenetrating complications
Cerebrovascular Trauma
Neck Injuries epidemiology
Neck Injuries complications
Spinal Injuries
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8171
- Volume :
- 75
- Database :
- MEDLINE
- Journal :
- The American journal of emergency medicine
- Publication Type :
- Academic Journal
- Accession number :
- 37924732
- Full Text :
- https://doi.org/10.1016/j.ajem.2023.10.039