Section of Legal and Forensic Medicine, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain.
University of New Haven, West Haven, CT 06516, USA.
Forensic Sci Int. 2022 Jan;330:111137. doi: 10.1016/j.forsciint.2021.111137. Epub 2021 Dec 3.
Drowning is a significant public health problem worldwide and the WHO reported that drowning is the world's third leading unintentional injury death. Nevertheless, there is still uncertainty regarding the estimate of local and global drowning deaths. In addition, the postmortem diagnosis of drowning is challenging and the physiological mechanisms of death by drowning are complex and not very well understood.
To analyze a large series of bodies retrieved from the water in Connecticut (U.S.) in order to compare epidemiologic and toxicological data with those of the literature, as well as to examine the weights of the lungs and brains in drowning deaths.
We conducted a descriptive, retrospective, population-based analysis of all bodies retrieved from the water and subjected to a forensic autopsy at the Office of the Chief Medical Examiner in Connecticut (2008-2020, n = 500). Variables collected were sex, age, date of death, location of drowning, season, type of water, cause of death, manner of death, circumstances of death, signs of decomposition, BMI, brain weight, lung weight, presence of pulmonary edema, stomach contents, and toxicological analysis.
The death rates of drownings in Connecticut ranges from 0.75 to 1.28/100,000/year. They occurred predominantly in males (73.4%) and most were accidents (75.6%), though this gender difference diminishes in suicides (55.4% of males). Sex distribution is also different in bathtub drownings, where women drown more frequently (67.3%). Weights of the brains (p = 0.013) and lungs (p < 0.001) were higher in saltwater drownings.
Drowning is more frequently an accident involving men, except for suicides where there is only a slight difference among sex. Heavy lungs and cerebral edema continue to be identified in numerous drowning deaths. These anatomic findings, however, must still be interpreted in the context of the entire case investigation. Weights of the brains and lungs are higher in salt water, although these organs' weights are mostly dependent on other variables such as BMI and decomposition.
溺水是全球一个严重的公共卫生问题，世界卫生组织报告称，溺水是全球导致非故意伤害死亡的第三大原因。然而，对于当地和全球溺水死亡人数的估计仍然存在不确定性。此外，溺水的死后诊断具有挑战性，溺水导致死亡的生理机制复杂，尚未得到很好的理解。
分析在美国康涅狄格州从水中打捞的大量尸体，以便将流行病学和毒理学数据与文献进行比较，并检查溺水死亡者的肺和脑的重量。
我们对康涅狄格州首席法医办公室从水中打捞并进行法医尸检的所有尸体（2008-2020 年，n=500）进行了描述性、回顾性、基于人群的分析。收集的变量包括性别、年龄、死亡日期、溺水地点、季节、水的类型、死因、死亡方式、死亡情况、分解迹象、体重指数、脑重、肺重、肺水肿的存在、胃内容物和毒理学分析。
康涅狄格州的溺水死亡率为 0.75 至 1.28/100,000/年。溺水者主要为男性（73.4%），大多数为意外（75.6%），但在自杀中这种性别差异会减小（男性为 55.4%）。在浴缸溺水中，女性溺水的比例更高（67.3%），性别分布也不同。海水溺水者的脑重（p=0.013）和肺重（p<0.001）较高。
溺水更常是男性的意外事故，除了自杀者之间性别差异较小。在许多溺水死亡中，仍然可以发现肺部沉重和脑水肿。然而，这些解剖学发现仍必须在整个案例调查的背景下进行解释。尽管这些器官的重量主要取决于体重指数和分解等其他变量，但在海水中，脑和肺的重量更高。
