Abstract
Background
Medical treatment of hunger-strike patients, especially those in incarceration facilities,
may pose clinical and treatment challenges for the treating physicians.
Objective
The aim of our study is to describe the epidemiology and clinical and laboratory characteristics
of hunger-strike prisoners presenting to the emergency department (ED) and to describe
etiologies of hospitalization and complications among this group.
Method
We retrospectively examined clinical and laboratory manifestations of 50 hunger-strike
prisoners who were referred for evaluation to the ED after a longstanding fast.
Results
After a mean of 38 (28-44) days of a hunger strike, the most common complaints were
chest pain and abdominal pain (14/60 [23.3%], 13/60 [21.6%], respectively). Mean weight
loss percentage was 18.5%, and most patients were bradycardic (25/40 [62.5%]), and
some hypothermic (16/50, [32%]). We describe several laboratory disturbances observed
in these patients; leukopenia was the most common hematologic manifestation (31/50
[62%]), and a prolonged international normalized ratio was observed in 12/29 (41.3%)
patients. We hospitalized 12% of the patients; the most common hospitalization cause
was bradycardia (3/6 [50%]).
Conclusions
Our study found that the most common clinical symptom was chest pain, which has not
been previously reported among hunger strikers. We observed a substantial number of
laboratory disturbances due to muscle wasting and protein loss and due to presumed
vitamin and micronutrient deficiencies. We suggest monitoring electrocardiograms for
heart rate, blood count, chemistry, coagulation tests, and vitamin levels.
Keywords
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Article info
Publication history
Published online: May 30, 2018
Accepted:
April 20,
2018
Received in revised form:
March 15,
2018
Received:
November 9,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
