Reys L L, Santos J C
Institute of Legal Medicine, University School of Medicine, Lisbon, Portugal.
Am J Forensic Med Pathol. 1992 Mar;13(1):33-6. doi: 10.1097/00000433-199203000-00007.
Information in forensic toxicology plays a very important role. The forensic pathologist usually seeks toxicologic analyses on basis of the information available at the time of the medicolegal autopsy. Such information may be obtained from different sources: hospitals, authorities, relatives, friends, or neighbors of the deceased and, obviously, macroscopic findings at the time of the autopsy. In order to evaluate the relative importance of these different sources of information, the authors have studied, retrospectively, results of 580 postmortem examinations performed at the Institute of Legal Medicine of Lisbon, wherein toxicologic analyses had been requested. These cases pertain to the years 1987 and 1988, but do not include alcohol determination in the blood in cases of traffic accidents. In 274 (47.4%) of the 580 cases, there were positive findings while in the remaining 306 (52.6%) findings were negative. In cases with positive findings, circumstances and factors, which may have influenced the pathologist's decision to request toxicologic analysis, are discussed. In more than half the cases, hospital information was the decisive factor, while in approximately 25% of the cases, autopsy findings were the justification. In contrast, it is worth mentioning that in approximately 45% of the cases with analytical negative results, requests were made, in cases of blank autopsies, for toxicologic analyses in order to exclude the possibility of poisoning. It is interesting to note that in the same proportion requests were justified on grounds of hospital information. Some of the factors that may explain this apparent discrepancy are discussed. Finally, the relevance of background information is emphasized at the level of the interpretation of analytical results, whether positive or negative.(ABSTRACT TRUNCATED AT 250 WORDS)
法医毒理学中的信息起着非常重要的作用。法医病理学家通常根据法医尸检时可获得的信息寻求毒理学分析。此类信息可从不同来源获取:医院、当局、死者的亲属、朋友或邻居,显然还有尸检时的宏观检查结果。为了评估这些不同信息来源的相对重要性,作者回顾性研究了在里斯本法医学研究所进行的580例尸体解剖的结果,这些解剖均要求进行毒理学分析。这些病例涉及1987年和1988年,但不包括交通事故案件中血液中的酒精检测。在580例病例中,274例(47.4%)有阳性结果,其余306例(52.6%)结果为阴性。对于有阳性结果的病例,讨论了可能影响病理学家要求进行毒理学分析的决定的情况和因素。在超过一半的病例中,医院信息是决定性因素,而在大约25%的病例中,尸检结果是进行分析的理由。相比之下,值得一提的是,在大约45%分析结果为阴性的病例中,在空白尸检的情况下要求进行毒理学分析,以排除中毒的可能性。有趣的是,基于医院信息提出请求的比例相同。文中讨论了一些可能解释这种明显差异的因素。最后,强调了背景信息在分析结果解释层面的相关性,无论结果是阳性还是阴性。(摘要截选至250字)