在死亡后检查(PME)中记录了致命的颈部外部压迫病例中颈部受伤的模式,协助解释导致死亡的情况。在这项研究中,对2016年至2020年在爱尔兰发生的298例悬吊和绞窄的PME进行了回顾性审查,目的是记录和整理每次PME期间观察到的外部和内部颈部损伤。以及每个死者的毒理学结果。进行了统计分析,以研究与死者有关的人体测量变量与绞死和绞死情况下的PME发现之间的潜在新关联。用于为该领域的现有研究机构添加更多数据,并协助解决未来的绞刑或勒死案例,这些案例有相互矛盾的发现。在完成统计分析时,研究发现,颈内软骨骨折(CNFs)的发生与结扎带宽度的增加没有明显的关联.确定了死者的体重增加与BMI之间的正相关关系,并且确定了死者身高的增加与CNF的发生率之间的显着正相关。毒理学分析表明,抗精神病药在与CNF相关的不完全和完全悬挂的情况下最常见,而阿片类药物在与CNF相关的手动和结扎绞窄的情况下最常见。
目的:记录回顾性悬吊和手动/绑扎勒死病例中颈部受伤的模式,并整理这些发现,以提供科学证据,以支持对未来的自杀悬吊和杀人手动/绑扎勒死病例的发现的解释,以进行法医学调查。在完全悬挂的情况下,分析颈部骨折的发生与受害者的人体测量变量之间的关联。
方法:回顾性回顾了2016年至2020年在爱尔兰进行的298例尸体后检查(PME)的报告。每个报告都记录了伪匿名数据集,其中包括以下参数:颈部损伤(软组织和软骨),体重,高度,BMI和绑带宽度,毒理学,绞索位置,结扎材料,舌头突出,性别和年龄。已向参与这些病例的病理学家和验尸官寻求使用这些数据的许可。采用描述性统计方法和logistic回归分析。
结果:进行了Logistic回归分析,以检查绑扎线宽度的单位增加与死者一组身体特征的增加之间的关联(体重,BMI和身高)与CNFs的发生有关。没有发现增加结扎线宽度会增加发生CNF的可能性,其中该事件发生的几率(OR)为0.9596。发现体重和BMI的单位增加分别增加了OR为1.0166和1.0607的CNF发生的可能性。死者身高的增加产生OR=4.64,表明CNF随着身高的增加而发生的可能性显着增加(CI95%:0.2915,73.9559)。
结论:根据本研究的统计分析,增加体重,身高和BMI是死者的参数,这些参数在完全悬挂的情况下增加了CNF发生的可能性。
The pattern of neck injuries sustained in fatal cases of external compression to the neck is recorded during Post Mortem Examinations (PME), to assist in the interpretation of the circumstances that led to death. In this study, the PMEs performed for 298 cases of hanging and strangulation occurring between 2016 and 2020 in Ireland were retrospectively reviewed for the purpose of recording and collating the external and internal neck injuries observed during each PME, as well as the toxicology results for each decedent. Statistical analysis was performed to investigate potential novel associations between anthropometric variables pertaining to the decedents and the PME findings in cases of hanging and strangulation, serving to add further data to the existing body of research in this area and to assist in the resolution of future cases of hanging or strangulation where there are conflicting findings. In completing statistical analysis, it was found that there was no discernible association between the occurrences of cartilaginous neck fractures (CNFs) with increasing ligature width. Positive associations between increasing weight and BMI of the decedents were identified, and a significantly positive association between the increasing height of the decedent and the incidence of CNFs were identified. Analysis of the toxicology demonstrated that antipsychotics were implicated most frequently in cases of incomplete and complete hanging associated with CNFs and that opioids were implicated most frequently in cases of manual and ligature strangulation associated with CNFs.
OBJECTIVE: To record the pattern of neck injuries sustained in retrospective cases of hanging and manual/ligature strangulation and to collate these findings so as to provide scientific evidence to support the interpretation of the findings in future cases of suicidal hanging and homicidal manual/ligature strangulation for the purpose of medicolegal investigation. To analyse the associations between the occurrence of neck fractures and anthropometric variables pertaining to the victims in cases of complete hanging.
METHODS: The reports of 298 Post Mortem Examinations (PMEs) performed for cases of hanging and manual/homicidal ligature strangulation between 2016 and 2020 in Ireland were retrospectively reviewed. Pseudoanonymised data sets were recorded for each report, which included the following parameters: neck injuries (soft tissue and cartilaginous), weight, height, BMI and ligature width, toxicology, noose position, ligature material, tongue protrusion, sex and age. Permission for the use of this data was sought from the pathologists and coroners involved in these cases. The data was analysed according to descriptive statistical methods and logistic regression analysis.
RESULTS: Logistic regression analysis was undertaken to examine the associations between unit increases in ligature width and increases in a set of physical characteristics of the decedents (weight, BMI and height) with the occurrence of CNFs. Increasing ligature width was not found to increase the likelihood of a CNF occurring, where the Odds Ratio (OR) for this event occurring was 0.9596. Unit increases in body weight and BMI were found to increase the likelihood of the occurrence of a CNF with ORs of 1.0166 and 1.0607 respectively. Increasing height of the decedent yielded an OR = 4.64, demonstrating that CNFs are significantly more likely to occur with increasing height (CI 95 %: 0.2915, 73.9559).
CONCLUSIONS: According to the statistical analysis performed for this study, increasing weight, height and BMI are parameters of the decedents which increase the likelihood of the occurrence of CNFs in cases of complete hanging.