Costa Margarida, Silva Beatriz S, Real Francisco C, Teixeira Helena M
National Institute of Legal Medicine and Forensic Sciences, Portugal.
National Institute of Legal Medicine and Forensic Sciences, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Forensic Sci Int. 2019 Jun;299:1-5. doi: 10.1016/j.forsciint.2019.03.016. Epub 2019 Mar 15.
The presented manuscript describes the carbon monoxide (CO) related deaths in Portugal over a period of 3 years, based on autopsies carried out at the National Institute of Legal Medicine and Forensic Sciences, from January 2012 to December 2014. Three hundred and forty-seven forensic autopsy reports with carboxyhaemoglobin (COHb) analysis requests were analysed and subdivided into three main groups: (1) improbable CO intoxication; (2) possible CO intoxication; (3) highly probable CO intoxication. In group 1, COHb analysis was negative, and the death circumstances, as well as the post mortem findings, didn't corroborate an exposition to CO. In group 2, with COHb positive in 1/3 of the cases, the death circumstances corroborated an exposition to CO, but the post mortem findings weren't enough to confirm an exposition to this substance. In group 3, the results of COHb were positive, and both circumstances of death and post mortem findings corroborated an exposition to CO. The first group (113 cases) had no specific suspicion of a CO intoxication and, thus, the request of a COHb analysis had no particular basis, reflected in the low COHb achieved percentage (between 0 and 12). In the second group (164 cases), 29% of the cases were directly or indirectly related to CO exposure (between 0% and 94%). In the third group (70 cases), 56 deaths were due to CO intoxication and 14 due to burns after CO inhalation (between 18% and 91%). This study intended to do, not only a 3-year assessment of CO poisoning, but also to enhance the fact that circumstantial information, as well as a correct evaluation at the forensic autopsy data are crucial, and allow an enhanced diagnosis of possible intoxication, as well as a better guidance for the consequent toxicological analysis requests.
所提交的手稿描述了2012年1月至2014年12月期间在葡萄牙发生的与一氧化碳（CO）相关的死亡情况，这些数据基于在国家法医学和法医学研究所进行的尸检。对347份有碳氧血红蛋白（COHb）分析请求的法医尸检报告进行了分析，并分为三个主要组：（1）不太可能的CO中毒；（2）可能的CO中毒；（3）极有可能的CO中毒。在第1组中，COHb分析为阴性，死亡情况以及尸检结果均不支持接触过CO。在第2组中，三分之一的病例COHb呈阳性，死亡情况支持接触过CO，但尸检结果不足以证实接触过该物质。在第3组中，COHb结果呈阳性，死亡情况和尸检结果均支持接触过CO。第一组（113例）没有对CO中毒的具体怀疑，因此，进行COHb分析的请求没有特别依据，这反映在获得的低COHb百分比（0至12之间）上。在第二组（164例）中，29%的病例与CO暴露直接或间接相关（0%至94%之间）。在第三组（70例）中，56例死亡是由于CO中毒，14例是由于吸入CO后烧伤（18%至91%之间）。本研究不仅旨在对CO中毒进行为期三年的评估，还旨在强调间接信息以及对法医尸检数据的正确评估至关重要，有助于加强对可能中毒的诊断，并为随后的毒理学分析请求提供更好的指导。
