Delayed deaths in near hanging cases- An autopsy study of causes and associated factors

Background Near hanging cases are those who survive an attempt of hanging injury for varied duration. Such cases while being hospitalised succumb to complications resulting in delayed deaths. This study evaluates various factors associated with delayed causes of death in near hanging cases and provides insight in improving the emergency services. Material Methods A prospective autopsy based study was conducted at the Department of Forensic Medicine, M.S. Ramaiah Medical College between 2012 and 2021. All near hanging cases who were hospitalised and later having succumbed to complications and subsequently subjected for medico-legal autopsy were included in the study. Results Females in the age group of 19-30 yrs were commonly the victims. More than half of them could reach the hospital within 30 mins to 1 hour. 47.8 % of them were suspended for between 1 to 3 mins. 65% survived for more than a day. Partial hanging with faint ligature mark was more common. 95.7% of them had taken off from a platform with falling height of less than 1 metre. Cerebral oedema and consolidation were the common post mortem findings in brain and lungs. Cause of death was attributed to hypoxic encephalopathy in majority of the cases. Conclusion Longer the duration of suspension, more the height of fall, no history of contact with ground while being suspended, cerebral oedema, hypoxia, pulmonary oedema, hypotension and need for resuscitation are the predictors of fatal outcome in near hanging cases.