WMU Homer Stryker M.D. School of Medicine, 300 Portage Street, Kalamazoo, MI, 49007.
J Forensic Sci. 2020 Nov;65(6):2008-2012. doi: 10.1111/1556-4029.14524. Epub 2020 Aug 3.
The contribution of positional asphyxia in opioid-related deaths is currently unknown. Diagnostic criteria for positional asphyxia include finding the decedent in a position that does not allow for adequate respiration and an inability to extricate themselves from the position due to various conditions. Our primary objective was to assess whether positional asphyxia and the resulting airway compromise were a contributing factor to death due to the toxic effects of opioids. We evaluated 225 deaths where the death scene investigation contained adequate information to evaluate for positional asphyxia and performed a Pearson chi-square test to determine if the proportion of deaths found in an airway compromising position was higher when opioid(s) caused the death. The proportion of decedents found in a potential airway compromising position was greater when the death was related to opioid use (p < 0.0001). Further, narrowing the dataset to decedents who were definitely in an airway compromising position [Yes (24.49%) vs. No (11.02%)] showed a statistically significant association between positional asphyxia and deaths related to opioid use (p = 0.0021). Carefully documenting the position in which the decedent was initially found may be a significant factor in accurate reporting and in harm reduction efforts to decrease the opioid mortality rate.
目前尚不清楚位置性窒息在阿片类药物相关死亡中的作用。位置性窒息的诊断标准包括发现死者处于一种无法进行充分呼吸的姿势，并且由于各种原因无法从该位置解脱出来。我们的主要目的是评估位置性窒息和由此导致的气道阻塞是否是阿片类药物毒性作用导致死亡的一个促成因素。我们评估了 225 例死亡案例，这些死亡案例的现场调查包含了足够的信息来评估位置性窒息，并进行了 Pearson 卡方检验，以确定在因阿片类药物导致的死亡中，处于气道阻塞位置的死亡比例是否更高。当死亡与阿片类药物使用有关时，处于潜在气道阻塞位置的死者比例更高（p<0.0001）。此外，将数据集缩小到明确处于气道阻塞位置的死者[是（24.49%）与否（11.02%）]，显示位置性窒息与阿片类药物使用相关的死亡之间存在统计学显著关联（p=0.0021）。仔细记录死者最初被发现时的位置可能是准确报告和减少阿片类药物死亡率的减少伤害努力中的一个重要因素。
