美国内布拉斯加州儿童死亡的法医流行病学。

Forensic epidemiology of childhood deaths in Nebraska, USA.

作者信息

Okoye Cordelia N, Okoye Matthias I

机构信息

Nebraska Institute of Forensic Sciences, Inc., Lincoln, NE 68516, USA.

出版信息

J Forensic Leg Med. 2011 Nov;18(8):366-74. doi: 10.1016/j.jflm.2011.07.013. Epub 2011 Aug 27.

DOI:10.1016/j.jflm.2011.07.013

PMID:22018169

Abstract

In a 7-year period (April 1, 2003-March 31, 2010), all medico-legal childhood deaths aged 0-18 years investigated by the Lancaster County Coroner's Office under the auspices of Nebraska Institute of Forensic Sciences, Inc. (NIFS), were retrospectively reviewed (n = 140). This number of cases represents 10.9% of the 1287 forensic autopsies performed during the same period. Age, race, gender, cause and manner of deaths were analyzed for all victims categorized into five age groups: 0-1 year, 1-4 years, 5-9 years, 10-14 years, and 15-18 years. Male victims predominated with 98 cases (70%) versus 42 cases (30%) for females giving a male to female ratio of 2.3: 1. The mean age of the children was 7.6 years. The racial composition was 86.4% white, 10.7% Hispanic, 0.7% American Indian, 1.4% African American, and 0.7% Asian American. The majority of deaths occurred in the 0-1 age group (50 cases), followed in rank order by the 15-18 age group (40 cases), the 1-4 age group (23 cases), the 10-14 age group (17 cases), and the 5-9 age group (10 cases). The most common manner of death was accident, followed by natural, suicide, homicide, and undetermined. Accidents accounted for 71 cases (50.7%) of all the deaths and are amenable to prevention. Accidental blunt force trauma accounted for 41 cases or 58% of all the accident cases. The share of motor vehicle crashes in total blunt force trauma deaths was 33 cases. Natural deaths comprised 42 cases or 30% of all the deaths. Suicide (19 cases or 13.6% of all the deaths) was only encountered in the older age groups, the 10-14 age group (6 cases) and the 15-18 age group (13 cases). However, homicide which was observed as the least common manner of death (7 cases) was more predominant among the younger age groups (0-1 and 1-4 age groups). This review may provide useful information for the forensic pathologist, death investigators, law enforcement officers, policy makers, healthcare providers and Nebraska Child Death Review Team in predicting, preventing and investigating childhood medico-legal deaths.

摘要

在7年期间（2003年4月1日至2010年3月31日），对兰卡斯特县验尸官办公室在 Nebraska Institute of Forensic Sciences, Inc.（NIFS）主持下调查的所有0至18岁的儿童法医学死亡案例进行了回顾性审查（n = 140）。这一案例数量占同期进行的1287例法医尸检的10.9%。对所有受害者按年龄分为五个年龄组进行了年龄、种族、性别、死亡原因和方式的分析：0至1岁、1至4岁、5至9岁、10至14岁和15至18岁。男性受害者居多，有98例（70%），女性为42例（30%），男女比例为2.3:1。儿童的平均年龄为7.6岁。种族构成是86.4%为白人，10.7%为西班牙裔，0.7%为美洲印第安人，1.4%为非裔美国人，0.7%为亚裔美国人。大多数死亡发生在0至1岁年龄组（50例），其次依次是15至18岁年龄组（40例）、1至4岁年龄组（23例）、10至14岁年龄组（17例）和5至9岁年龄组（10例）。最常见的死亡方式是意外事故，其次是自然死亡、自杀、他杀和死因不明。意外事故占所有死亡案例的71例（50.7%），且可预防。意外钝器伤占所有意外事故案例的41例，即58%。机动车碰撞在所有钝器伤死亡案例中的占比为33例。自然死亡有42例，占所有死亡案例的30%。自杀（19例，占所有死亡案例的13.6%）仅出现在较大年龄组，即10至14岁年龄组（6例）和15至18岁年龄组（13例）。然而，作为最不常见死亡方式的他杀（7例）在较年轻年龄组（0至1岁和1至4岁年龄组）中更为常见。本综述可为法医病理学家、死亡调查人员、执法人员、政策制定者、医疗服务提供者以及 Nebraska Child Death Review Team 在预测、预防和调查儿童法医学死亡方面提供有用信息。