Low Rates of Injury in Neurologically Normal Strangulation Victims

Many clinicians maintain a low threshold for obtaining vascular imaging after strangulation to identify cervical artery injury. These authors retrospectively assessed rates of imaging and injury in patients with near hanging or manual strangulation at a single academic Level I trauma center.

Patients aged 16 years or older with Glasgow Coma Scale scores ≥13 were identified from trauma and forensic nurse databases and a data warehouse. Independent abstractors, masked to outcomes, coded symptoms and signs from the medical record with good agreement (kappa, 0.84). Clinically significant injuries were defined as injuries requiring treatment or observation for >24 hours.

Among 349 patients (21 near hangings and 328 manual strangulations; 90% women…