Anzillotti Luca, Marezza Francesca, Calò Luca, Cucurachi Nicola, Veronesi Licia, Cecchi Rossana
Institute of Legal Medicine, Department of Medicine and Surgery, University of Parma, Italy.
Institute of Legal Medicine, Department of Medicine and Surgery, University of Parma, Italy.
J Forensic Leg Med. 2019 Feb;62:92-96. doi: 10.1016/j.jflm.2019.01.011. Epub 2019 Jan 18.
The aim of this study was to collect all available data from 2009 to 2016 focusing on the epidemiological, clinical and pharmacological issues only related to acute intoxication fatalities in the Unit of Legal Medicine of the Department of Medicine and Surgery at the University of Parma. All death certificates and autopsy reports were retrieved from the archives and evaluated to identify cases in which only acute intoxication from xenobiotics could be defined as the cause of death, however statistical and descriptive analyses were applied to all the data. A more comprehensive analysis on all causes of death showed that out of 1005 total cases the most common is haemorrhagic shock/traumatic shock (36.5%), followed by cardiogenic shock with 27.4%; asphyxia ranks as the third cause of death (11.8%); concerning encephalic injuries, our data show 10.9% of cases, while acute intoxication by xenobiotics accounts for 5.7%. Data show that the majority of subjects are poly-abuser (75.4%); people not enrolled within a preventive treatment (59.4%) were more likely to commit suicide (28.1%), whereas only 6.2% in the sub-population in treatment (40.6%) committed suicide: therefore, data strongly suggest the evidence that joining a preventive programme can decrease the probability of extreme action. Access to a full case history may indeed save considerable time and expense in carrying out tests, but also valuable targeted samplings. The investigating officer should, therefore, submit as much information as possible about the case, as this may influence the type and extent of analysis undertaken, as well as the interpretation of analytical results.
本研究的目的是收集2009年至2016年所有可用数据,重点关注帕尔马大学医学与外科学系法医学科仅与急性中毒死亡相关的流行病学、临床和药理学问题。从档案中检索了所有死亡证明和尸检报告,并进行评估以确定仅外来化合物急性中毒可被定义为死亡原因的病例,不过对所有数据都进行了统计和描述性分析。对所有死亡原因进行的更全面分析表明,在1005例总病例中,最常见的是失血性休克/创伤性休克(36.5%),其次是心源性休克,占27.4%;窒息是第三大死亡原因(11.8%);关于脑损伤,我们的数据显示病例占10.9%,而外来化合物急性中毒占5.7%。数据表明,大多数受试者是多种药物滥用者(75.4%);未参加预防性治疗的人(59.4%)自杀可能性更大(28.1%),而接受治疗的亚人群中(40.6%)只有6.2%自杀:因此,数据有力地表明参加预防计划可降低采取极端行为的可能性。获取完整的病例史确实可以在进行检测时节省大量时间和费用,还能进行有价值的针对性采样。因此,调查官员应尽可能提交有关该病例的信息,因为这可能会影响所进行分析的类型和范围,以及分析结果的解释。