Laskey Antoinette L, Haberkorn Kelly L, Applegate Kimberly E, Catellier Michele J
Department of Pediatrics, Riley Hospital for Children, Children's Health Services Research, Indiana University School of Medicine, 410 West 10th Street, Suite 1020, Indianapolis, IN 46202, USA.
J Forensic Sci. 2009 Jan;54(1):189-91. doi: 10.1111/j.1556-4029.2008.00922.x. Epub 2008 Nov 21.
Recommendations for the evaluation of an unexplained death in infancy include a postmortem skeletal survey (PMSS) to exclude skeletal trauma. Objectives of this study were to assess adherence to these recommendations in forensic autopsies in children equal to or less than 36 months of age, and what factors influence the use or nonuse of the PMSS. We surveyed pathologists who were members of the American Academy of Forensic Sciences. The survey included practice characteristics about where, when, and how PMSS were done. Nearly all respondents (99.6%) indicated they performed PMSS at least some of the time; however, almost a third did not use PMSS for all suspected Sudden Infant Death Syndrome (SIDS), abuse, unsafe sleep, or undetermined causes of death. Despite evidence that "babygrams" are inappropriate in a SIDS workup, 30% of pathologists use them preferentially. Despite SIDS being a diagnosis of exclusion that requires a PMSS, almost 10% of pathologists do not order a PMSS. Future research is necessary to reduce barriers to this important component of the pediatric forensic autopsy.
对婴儿不明原因死亡的评估建议包括进行尸体骨骼检查（PMSS）以排除骨骼创伤。本研究的目的是评估在36个月及以下儿童的法医尸检中对这些建议的遵循情况，以及哪些因素会影响PMSS的使用或不使用。我们对美国法医科学学会的病理学家进行了调查。该调查包括关于PMSS在何处、何时以及如何进行的实践特征。几乎所有受访者（99.6%）表示他们至少有时会进行PMSS；然而，近三分之一的人并未对所有疑似婴儿猝死综合征（SIDS）、虐待、不安全睡眠或死因不明的情况使用PMSS。尽管有证据表明“婴儿X光片”在SIDS检查中不合适，但30%的病理学家优先使用它们。尽管SIDS是一种需要进行PMSS的排除性诊断，但近10%的病理学家并未安排PMSS。未来有必要开展研究以减少这一儿科法医尸检重要组成部分的障碍。
