ANALYSIS OF THE CLINICAL PROFILE AND OUTCOMES OF PATIENTS PRESENTING WITH STRESS CARDIOMYOPATHY AFTER SUICIDAL HANGING TO A MULTIDISCIPLINARY ICU IN SOUTH INDIA.

Corresponding Author:
Dr. Baby Sailaja K,
Assistant Professor,
Department of Critical Care Medicine,
Sri Ramachandra Medical College and
Research Institute, Chennai,
Tamilnadu, India.
E-mail: sailajaroop@gmail.com

ABSTRACT

BACKGROUND

Stress cardiomyopathy, a reversible left ventricular dysfunction, following suicidal hanging is an uncommon clinical entity among intensive care unit (ICU) admissions. As there is a dearth of data on this condition, we intended to study the clinical profile and outcomes of patients admitted to our multidisciplinary ICU with stress cardiomyopathy following an attempted suicidal hanging.

MATERIALS AND METHODS

An observational study was conducted for a period of seven years on consecutive suicidal hanging patients admitted to the ICU with stress cardiomyopathy Demographic details, severity of illness, interventions and outcomes of these patients were studied.

RESULTS

During the study period, 19 patients were admitted to our multidisciplinary ICU with left ventricular dysfunction compatible with stress cardiomyopathy following an attempted suicide by hanging. The patients in the study were young with a mean age of 26.89 years and showed a female predominance of 63%. Non survivors had a significantly low Glasgow Coma Scale (GCS) (Mean=3.67), high mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score (31.33) and low mean ejection fraction (25.83%) compared to survivors. Mechanical ventilation and vasopressor support were required in 89.5% and 68.4% patients respectively. We observed a mortality rate of 31.6% (n=6). Hospital stay and ICU free days were significantly shorter in non survivors reflecting their critical presentation from the time of admission. Due to the short course of stay in hospital of both survivors and non survivors we could not assess the reversal of the cardiac dysfunction in our study.

CONCLUSION

Stress cardiomyopathy being a reversible condition and considering the high mortality observed in our study further studies with a large sample size is needed for a better understanding of this condition in suicidal hanging patients.

KEY WORDS

Suicidal Hanging, Stress Cardiomyopathy, Pulmonary Oedema, Ejection Fraction, Reversed Takotsubo