Aitken Georgia, Murphy Briony, Pilgrim Jennifer, Bugeja Lyndal, Ranson David, Ibrahim Joseph Elias
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
Forensic Sci Med Pathol. 2017 Mar;13(1):52-57. doi: 10.1007/s12024-016-9830-9. Epub 2017 Jan 16.
There is a paucity of research examining the utility of forensic toxicology in the investigation of premature external cause deaths of residents in nursing homes. The aim of this study is to describe the frequency and characteristics of toxicological analysis conducted in external cause (injury-related) deaths amongst nursing home residents in Victoria, Australia. This study was a retrospective cohort study examining external cause deaths among nursing home residents during the period July 1, 2000 to December 31, 2012 in Victoria, Australia, using the National Coronial Information System (NCIS). The variables examined comprised: sex, age group, year-of-death, cause and manner of death. One-third of deaths among nursing home residents in Victoria resulted from external causes (n = 1296, 33.3%) of which just over one-quarter (361, 27.9%) underwent toxicological analysis as part of the medical death investigation. The use of toxicological analysis varied by cause of death with a relatively low proportion conducted in deaths from unintentional falls (n = 286, 24.9%) and choking (n = 36, 40.4%). The use of toxicological analysis decreased as the decedents age increased. Forensic toxicology has the potential to contribute to improving our understanding of premature deaths in nursing home residents however it remains under used and is possibly undervalued.
关于法医毒理学在养老院居民过早外因死亡调查中的作用，相关研究匮乏。本研究旨在描述澳大利亚维多利亚州养老院居民外因（与损伤相关）死亡中进行毒理学分析的频率及特征。本研究为回顾性队列研究，利用国家死因信息系统（NCIS），调查了2000年7月1日至2012年12月31日期间澳大利亚维多利亚州养老院居民的外因死亡情况。所考察的变量包括：性别、年龄组、死亡年份、死亡原因及方式。维多利亚州养老院居民中有三分之一的死亡是由外因导致的（n = 1296，33.3%），其中略超过四分之一（361，27.9%）在医学死亡调查中进行了毒理学分析。毒理学分析的使用因死亡原因而异，在意外跌倒死亡（n = 286，24.9%）和窒息死亡（n = 36，40.4%）中进行毒理学分析的比例相对较低。随着死者年龄的增加，毒理学分析的使用有所减少。法医毒理学有可能有助于增进我们对养老院居民过早死亡的理解，然而其应用仍然不足，可能也未得到充分重视。
