From the Department of Forensic Medicine, Moscow Regional Research and Clinical Institute ("MONIKI").
Department of Health Care Management and Economics, National Research University Higher School of Economics, Moscow, Russia.
Am J Forensic Med Pathol. 2022 Sep 1;43(3):231-235. doi: 10.1097/PAF.0000000000000764. Epub 2022 Jun 9.
Russia suffers from high alcohol-related mortality. Most forensic autopsies in Russia include blood alcohol tests, but a systematic analysis of these data has never been conducted for children's deaths.
We performed an analysis of juvenile mortality using autopsy reports from the Moscow Region Bureau of Forensic Medical Examination from January 1, 2009, to December 31, 2018.
Despite a decrease in incidence ( Rs = -0.661), the number of cases of alcohol intoxication in minors was still high. The mean age of children in our study was 14.77 years (95% confidence interval [CI], 14.31-15.23). Death was predominantly among boys (72%) and those with higher blood alcohol concentrations (mean difference [MD], 0.295; 95% CI MD , 0.012-0.58). The number of cases of unnatural death increased with age ( Rs = 0.746, P = 0.001). Accidents were the most predominant cause of death, followed by suicide, homicide, and natural causes. Fatal alcohol intoxication was observed at an average blood alcohol concentration of 3.58 g/L (95% CI, 1.46-5.7), without any specific signs on autopsy. Even a strong smell of alcohol is an unreliable sign in the clinic.
A systematic study of alcohol in forensic autopsy shows that the number of children who die with alcohol intoxication is high. Teenagers are the predominant age group experiencing alcohol intoxication. In our opinion, an alcohol blood test should be performed in all suspicious cases, especially in teenagers.
俄罗斯的酒精相关死亡率较高。俄罗斯的大多数法医解剖都包括血液酒精测试，但从未对儿童死亡进行过此类数据的系统分析。
我们使用 2009 年 1 月 1 日至 2018 年 12 月 31 日莫斯科地区法医检查局的尸检报告，对青少年死亡率进行了分析。
尽管发病率下降（Rs=-0.661），但未成年人酒精中毒的病例仍居高不下。我们研究中的儿童平均年龄为 14.77 岁（95%置信区间 [CI]，14.31-15.23）。死亡主要发生在男孩（72%）和血液酒精浓度较高的儿童中（平均差异 [MD]，0.295；95%CI MD，0.012-0.58）。非正常死亡的数量随着年龄的增长而增加（Rs=0.746，P=0.001）。事故是最主要的死亡原因，其次是自杀、他杀和自然原因。在平均血液酒精浓度为 3.58 g/L（95%CI，1.46-5.7）的情况下观察到致命性酒精中毒，尸检没有任何特定的迹象。即使有强烈的酒精气味在临床上也是不可靠的迹象。
对法医尸检中酒精的系统研究表明，死于酒精中毒的儿童数量较高。青少年是酒精中毒的主要年龄组。在我们看来，所有可疑病例，特别是青少年，都应进行酒精血液检测。
