在活着到达医院的患者中,绞刑是一种罕见的受伤机制,但死因裁判官办公室经常遇到。目前还不清楚是否经典描述了绞刑伤,如Hang子手骨折,在通常不从高处悬吊的当代绞刑患者中很常见。进行这项研究是为了确定绞刑导致死亡后的患者和受伤特征。
所有提交给洛杉矶县医学检查官/验尸官办公室(2016年1月至2020年5月)的因吊死而死亡的患者都包括在内。人口统计,精神病史,悬挂细节,尸检类型,并收集了持续的伤害。用描述性统计汇总数据变量,并计算结扎标记在诊断/排除宫颈损伤中的诊断率。
在研究中,1,401名患者死于绞刑。患者仅接受外部检查(n=1,282,92%),传统的颈部尸检(n=114,8%),或传统的颈部尸检加上死后计算机断层扫描(n=5,<1%)。房屋是最常见的悬挂环境(n=1,028,73%),其次是公共场所(n=80,6%)和监狱(n=28,2%)。死亡方式几乎完全是自杀(n=1,395,>99%),精神疾病很常见(n=968,69%)。在接受传统尸检的病人中,大多数有结扎痕迹(n=109,92%),只有9(8%)有颈椎损伤(舌骨骨折,n=6,5%;甲状软骨骨折,n=4,3%)。没有椎骨骨折/脱位。灵敏度,特异性,正预测值,结扎标记的阴性预测值为100%,5%,8%,和100%。
在洛杉矶县,绞刑是常见的死亡原因。患者通常有精神病史,几乎完全死于自杀。上吊通常发生在家里,在公共场所,在监狱里。损伤非常罕见,没有病人持续Hangman骨折,这可能与现代悬挂装置缺乏显著的悬挂有关。
Hangings are an infrequent wounding mechanism among patients arriving alive to hospital but are frequently encountered by the Coroner\'s Office. It is unclear if classically described hanging injuries, such as the Hangman\'s fracture, are common among contemporary hangings patients who typically do not suspend from height. This study was undertaken to define patient and injury characteristics after hangings causing death.
All patients presenting to the Los Angeles County Medical Examiner/Coroner\'s Office (January 2016 - May 2020) who died by hanging were included. Demographics, psychiatric history, hanging details, autopsy type, and sustained injuries were collected. Data variables were summarized with descriptive statistics and the diagnostic yield of a ligature mark in the diagnosis/exclusion of cervical injuries was calculated.
Over the study, 1,401 patients died by hanging. Patients underwent external exam alone (n = 1,282, 92%), traditional neck autopsy (n = 114, 8%), or traditional neck autopsy plus postmortem computed tomography scan (n = 5, <1%). Home was the most frequent hanging setting (n = 1,028, 73%) followed by public spaces (n = 80, 6%) and jail (n = 28, 2%). The manner of death was almost exclusively suicide (n = 1,395, >99%) and psychiatric disease was common (n = 968, 69%). Of the patients undergoing traditional autopsy, most had a ligature mark (n = 109, 92%) and only 9 (8%) had a cervical injury (hyoid fractures, n = 6, 5%; thyroid cartilage fractures, n = 4, 3%). None had a vertebral fracture/dislocation. Sensitivity, specificity, positive predictive value, and negative predictive value of a ligature mark were 100%, 5%, 8%, and 100%.
Hangings are a frequent cause of death in Los Angeles County. Patients typically have a psychiatric history and die almost exclusively from suicide. Hangings commonly occur at home, in public places, and in jail. Injuries were exceedingly rare and no patient sustained a Hangman\'s fracture, which may be related to the lack of significant suspension with modern hangings.