Cox D E, Sadler D W, Pounder D J
London Medicolegal Centre.
J Clin Pathol. 1997 Mar;50(3):197-201. doi: 10.1136/jcp.50.3.197.
To gather data on blood alcohol concentrations in a forensic necropsy population and to analyse the information on trends that may predict where alcohol testing is going to prove cost-effective.
Alcohol assays were performed on blood, urine, and vitreous samples in 1620 consecutive medicolegal necropsy examinations.
Alcohol was detected in only 7% of natural deaths from all causes and in four of 40 deaths categorised as unknown/obscure. Alcohol concentrations > or = 350 mg/100 ml were found in nine drug/alcohol abuse deaths (range 362-506 mg/100 ml), five accidental deaths (356-504 mg/100 ml), and one homicide victim (400 mg/100 ml). Those categorised as alcohol abusers were represented in all but one category of death (unknown/obscure deaths in males), showing that many true alcoholics die with their alcoholism rather than of it; 39% of males and 34% of females with histories of alcohol abuse had alcohol present in their blood at necropsy at concentrations > or = 50 mg/100 ml, v only 9% (male) and 6% (female) without such history.
The study highlights the problems of elderly and "hidden" alcoholics and illustrates cases where routine assays would provide additional significant information. Routine alcohol testing is useful in all cases of suspected unnatural death but universal testing of forensic necropsies is not cost-effective.
收集法医尸检人群的血液酒精浓度数据，并分析相关趋势信息，以预测酒精检测在哪些方面具有成本效益。
对连续1620例法医尸检的血液、尿液和玻璃体样本进行酒精检测。
在所有死因的自然死亡案例中，仅7%检测出酒精，在40例分类为不明/死因不明的死亡案例中，有4例检测出酒精。在9例药物/酒精滥用死亡案例（浓度范围362 - 506mg/100ml）、5例意外死亡案例（356 - 504mg/100ml）和1例凶杀案受害者（400mg/100ml）中发现酒精浓度≥350mg/100ml。除一类死亡案例（男性不明/死因不明死亡）外，酒精滥用者出现在其他各类死亡案例中，这表明许多真正的酗酒者死于酗酒相关疾病而非酗酒本身；有酗酒史的男性尸检时血液中酒精浓度≥50mg/100ml的比例为39%，女性为34%，而无此类病史的男性和女性这一比例仅分别为9%和6%。
该研究凸显了老年酗酒者和“隐性”酗酒者的问题，并举例说明了常规检测可提供额外重要信息的情况。常规酒精检测在所有疑似非自然死亡案例中均有用，但对法医尸检进行普遍检测不具有成本效益。
