Sudden and unexpected deaths in adults :an investigation of cases reported to Tygerberg Forensic Pathology Services from January 2001 - December 2005

[摘要] ENGLISH ABSTRACT: Background - The workload of the forensic pathologist and Forensic Pathology Servicesstaff is increased by the referral of potentially unnecessary natural cases to the ForensicPathology Services. The primary aims of the medico-legal autopsy are limited toestablishing a cause of death in presumed unnatural cases, and to exclude criminality ornegligence.Objective – To determine the final outcomes of forensic post-mortem examinations in'sudden and unexpected adult deaths over a 5 year period.Methods - An observational, retrospective, descriptive study was conducted. Suddenand unexpected adult deaths referred to Tygerberg Forensic Pathology Services between1 January 2001 and 31 December 2005 were reviewed. Data was collected from theautopsy reports, contemporaneous notes and hospital records.Findings – A total of 816 adult cases of sudden and unexpected death were referred toTygerberg Forensic Pathology Services over the 5 year period studied. Completeautopsies had been performed in 74% (601/816) of cases. The presumed manner of deathwas natural in 79 % of cases, and an increase in the number of natural cases autopsied peryear was noted over the 5-year study period. Diseases of the cardiovascular, respiratoryand central nervous systems were responsible for the majority of natural deaths.Infectious diseases were responsible for most deaths in the youngest age group studied(18-29 years). Acute alcohol poisoning was responsible for the deaths of 35 (6%) cases,with an average blood alcohol concentration of 0.38g/100mL in these cases. Eight deathswere drug-/substance related. Waiting times for blood alcohol and toxicology resultsincreased over the 5-year study period. No cause of death was found in 10.6% of cases.Conclusions -The questionnaire and interviewing structure could possibly be improved inorder to obtain better pre-autopsy information and to reduce the number of 'unnecessarymedicolegal autopsies, thereby reducing the burden of cost on the Forensic PathologyServices.

[发布机构] Stellenbosch University