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

BACKGROUND: Near-hanging refers to individuals who survive a hanging injury for various durations. However, hospitalized patients succumb to complications resulting in delayed deaths.

AIM: to evaluate various factors associated with causes of delayed death in near-hanging events and provide insight into the improvement of emergency services.

MATERIALS AND 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 of hospitalized patients who later succumbed to complications and were subsequently subjected to medicolegal autopsy were included in the study.

RESULTS: Victims were commonly women aged 19–30 years. More than half of them could reach the hospital within 30 min to 1 hour, and 47.8% of them were suspended for between 1–3 min. Moreover, 65% survived for more than a day. Partial hanging with a faint ligature mark was more common, and 95.7% of them had taken off from a platform with a falling height of <1 metre. Cerebral edema and consolidation were the common postmortem findings in the brain and lungs. Death was attributed to hypoxic encephalopathy in the majority of the cases.

CONCLUSION: Longer the duration of suspension, higher fall height, noncontact with the ground while being suspended, cerebral edema, hypoxia, pulmonary edema, hypotension, and need for resuscitation are predictors of fatal outcomes in near-hanging events.