Sauvageau Anny, Racette Stéphanie
Laboratoire de sciences judiciaires et de médecine légale, Montreal, Canada.
Am J Forensic Med Pathol. 2008 Jun;29(2):145-7. doi: 10.1097/PAF.0b013e318174f0d0.
Postmortem changes are well known for their possible misinterpretation as traumatic lesions which can mislead to suspicion of violent death and therefore to a forensic autopsy request. As far as we know, a systematic review of the prevalence of such a reason for coroner's autopsy request has not been done yet. A retrospective study of 230 forensic autopsies requested by the Coroner's office from 2002 to 2004 in the province of Quebec, Canada, was conducted by the authors. Of the 230 reviewed cases, postmortem artifacts mistaken for traumatic lesions were found in 18 cases. These misinterpretation were based on 5 categories of portmortem changes: purge fluid drainage in 12 cases (66.7%), bluish discoloration by lividity in 5 cases (27.8%), parchment-like drying of the skin in 4 cases (22.2%), bloating from gas formation in 4 cases (22.2%), and skin slippage in 1 case (5.56%). Therefore, postmortem artifacts misinterpretation occurred in 7.83% (95% confidence interval 0.05-0.12) of all requested forensic autopsies and in 35.29% (95% confidence interval 0.23-0.50) of decomposed autopsy cases. This study clearly establishes the high prevalence of postmortem artifacts as main reason for forensic autopsy request. Hence, in a context of forensic pathologist shortage, the improvement of coroner continuous training may reduce the workload.
死后变化因其可能被误判为创伤性损伤而广为人知，这可能会导致对暴力死亡的怀疑，进而引发法医尸检请求。据我们所知，尚未对验尸官提出尸检请求的此类原因的发生率进行系统综述。作者对加拿大魁北克省验尸官办公室在2002年至2004年期间要求进行的230例法医尸检进行了回顾性研究。在230例经审查的病例中，有18例发现死后人为现象被误认为是创伤性损伤。这些误判基于5类死后变化：12例（66.7%）有清洗液引流，5例（27.8%）有尸斑导致的皮肤青紫，4例（22.2%）有皮肤呈羊皮纸样干燥，4例（22.2%）有气体形成导致的腹胀，1例（5.56%）有皮肤脱落。因此，在所有要求进行的法医尸检中，死后人为现象误判发生率为7.83%（95%置信区间0.05 - 0.12），在尸体已分解的尸检病例中为35.29%（95%置信区间0.23 - 0.50）。这项研究明确证实了死后人为现象作为法医尸检请求主要原因的高发生率。因此，在法医病理学家短缺的情况下，改进验尸官的持续培训可能会减轻工作量。
