Clinical Characteristics and Outcomes of Adult Patients Presenting to the Emergency Department After Hanging: An Eight-Year Retrospective Study

<title>Abstract</title> <p>Background Hanging-related injuries are uncommon but potentially fatal emergencies. This study aimed to describe the demographic, clinical, laboratory, and imaging characteristics of adults presenting to the emergency department following hanging and to identify factors associated with in-hospital mortality. Methods This retrospective, observational, single-center study included adult patients presenting to the emergency department of a tertiary care hospital between January 2018 and December 2025. Patients were identified using the International Classification of Diseases, 10th Revision codes X70 and Y20, and eligibility was confirmed through medical record review. Survivors and non-survivors were compared using the independent-samples Student’s t-test or Mann–Whitney U test for continuous variables and the Pearson chi-square or Fisher’s exact test for categorical variables, as appropriate. Results A total of 99 patients were included, of whom 78.8% were male. The median age was 30 years (interquartile range, 21–40.5), and in-hospital mortality was 12.1% (12/99). Cardiac arrest on presentation occurred in 91.7% of non-survivors but in none of the survivors (p &lt; 0.001). Complete suspension was observed in all non-survivors compared with 11.5% of survivors (p &lt; 0.001). Non-survivors had significantly lower Glasgow Coma Scale scores (median, 3 vs. 15; p &lt; 0.001), more severe metabolic acidosis and base deficit, and higher lactate and several other biochemical marker levels (all p &lt; 0.05). Cerebral edema was detected in 50.0% of non-survivors but in none of the survivors (p &lt; 0.001). Conclusions Cardiac arrest on presentation, complete suspension, severe neurological impairment, metabolic derangement, and cerebral edema were associated with in-hospital mortality following hanging. These findings may support early risk stratification in the emergency department. Larger multicenter studies are required to identify independent predictors of mortality and determine the safety of selective imaging strategies.</p>