Summary
Aim of the study. To analyze the deaths of persons who hanged themselves in Vilnius County, focusing on cases where death did not occur suddenly but over a while after developing anoxic brain injury. To assess the prevalence, demographics, medical management, vital signs, and complications of these cases.
Material and methods. A retrospective analysis of the State Forensic Medical Service’s anonymized autopsy data from 2014 to 2023 was conducted. Cases of near-hanging, in which anoxic brain injury was one of the complications leading to death, were selected. Statistical data analysis was performed using Microsoft Office Excel.
Results. From 2014 to 2023 in Vilnius County, out of 2149 cases of hanging, near-hanging with anoxic brain injury was diagnosed in 10 cases. Males made up 80% of the sample. The average age of the subjects was 44.5 ± 17.7 years. Most of the hangings took place in a prison (40%). The average duration of initial cardiopulmonary resuscitation (CPR) was 9.4 ± 2.9 minutes. The duration of CPR performed by Emergency Medical Services averaged 22.6 ± 10.2 minutes. On average, inpatient treatment was initiated within 2.49 ± 0.9 hours. During the initial condition assessment at the medical facility, the average respiratory rate was 16 ± 4.9 breaths per minute, systolic blood pressure (BP) – 102.3 ± 31.6 mmHg, diastolic BP – 63.4 ± 21.8 mmHg, heart rate – 105 ± 21.9 beats per minute, and Glasgow Coma Scale score – 4.4 ± 3.3. The mean duration of coma was 6.8 ± 10.3 days. Patients survived an average of 8.7 ± 15.8 days. The condition was often complicated by respiratory and heart failure (80%) and pneumonia (50%). The thyroid cartilage was fractured in one subject. Data on the use of psychoactive substances were present in 40% of the cases.
Conclusions. Near-hanging cases with anoxic brain injury are rare in Vilnius County. A trend of these cases has been observed among persons in prison or using psychoactive substances. Along with anoxic brain injury and coma, the most common complications were respiratory and heart failure, as well as pneumonia. Patients had severe impairment of vital functions, and the average survival was 8.7 days.
