Hanging and Strangulation Injuries: An Institutional Review From a Level 1 Pediatric Trauma Center

We sought to define the incidence and outcomes of pediatric hanging and strangulation injuries to inform best practices for trauma triage and management. A retrospective review was conducted that included all patients who presented after hanging or strangulation to a Level I Pediatric Trauma Center...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pediatric surgery 2023-10, Vol.58 (10), p.1995-1999
Main Authors: Swendiman, Robert A., Scaife, Jack H., Barnes, Kacey L., Bell, Teresa M., Roach, Christopher M., Iyer, Rajiv R., Brockmeyer, Douglas L., Russell, Katie W.
Format: Article
Language:English
Subjects:
Cervical spine
Hanging
Pediatric
Strangulation
Trauma
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We sought to define the incidence and outcomes of pediatric hanging and strangulation injuries to inform best practices for trauma triage and management. A retrospective review was conducted that included all patients who presented after hanging or strangulation to a Level I Pediatric Trauma Center from 2011 through 2021. Patient demographics, injury characteristics, and clinical outcomes were collected. All imaging modalities of the head and neck were reviewed to determine if a bony fracture or vascular injury was present. Over the 11-year study period, 128 patients met inclusion criteria. The median age of the cohort was 13 years [IQR: 8.5–15], most patients were male (60.9%), and the median GCS was 11 [3, 15]. There were 96 cases (75%) that were intentional injuries. 76 patients (59.4%) received imaging in the form of plain radiographs, CT, or MRI of the neck and cervical spine. No fractures were identified and there were 0 clinically significant cervical spine injuries. CT angiograms of the neck identified no cerebral vascular injuries. Mortality was high (32%), and 25% of patients with nonaccidental injuries had a documented prior suicide attempt. We identified no cervical spine fractures and no blunt cerebral vascular injuries after a hanging or strangulation in over 10 years at a Level 1 Pediatric Trauma Center. Use of CT and CT angiography of the neck and cervical spine should be minimized in this patient population without high clinical index of suspicion and/or significant mechanism. IV. •What is currently known about this topic?•Cross-sectional imaging is utilized to diagnose cervical spine fractures and blunt cerebral vascular injuries after pediatric hangings or strangulations. However, the incidence of these injuries is rare.•What new information is contained in this article?•In over 10 years at a Level I Pediatric Trauma Center, we identified no cervical spine fractures or blunt cerebral vascular injuries in this patient population.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2023.02.056