Characteristics of hemorrhages located at the origin of the sternocleidomastoid muscle in suicidal hangings: A retrospective autopsy study.

Aleksa Leković, Slobodan Nikolić
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Abstract

The study aimed to determine the incidence, distribution, and relation to the knot in a noose position of the sternocleidomastoid (SCM) muscle origin hemorrhages in hangings and to assess their occurrence regarding the subjects' major anthropometric characteristics. A retrospective study on 126 cases of suicidal hangings was conducted. Data on the subject's age, body weight and height, thyrohyoid and cervical spine fractures, and presence and distribution of SCM muscle origin hemorrhages were collected. The SCM muscle origin hemorrhage distribution regarding the knot position was analyzed by descriptive statistics and comparing characteristics between typical and atypical hangings, anterior and lateral hangings, and left and right lateral hangings. Median age was 55 years (17-94), body weight was 70.0 kg (40-125), body height was 176.0 cm (145-205). The hemorrhages were present in 108 (85.7%) cases. Bilateral hemorrhages were most common in the anterior knot position (5 of 7 cases, 71.4%), followed by the posterior knot position (N = 33, 53.2%). Unilateral SCM muscle origin hemorrhage was most common in lateral knot positions (N = 20, 35.1%). In lateral hangings, left SCM muscle origin hemorrhage (aOR = 5.76, 95% CI 1.64-20.19) and absence of right SCM muscle origin hemorrhage (aOR = 6.06 95% CI 1.48-24.78) were significantly associated with the left side of the knot. Body weight (≥67.5 kg) was a significant predictor of these hemorrhages (AUC = 0.639, p < 0.05, sensitivity 62.0%, specificity 66.7%). Hemorrhages at the origin of SCM muscles are a common autopsy finding in suicidal hangings, and knot position impacts their occurrence and distribution.

自杀悬吊中胸锁乳突肌起源处出血的特征:回顾性尸检研究。
本研究旨在确定悬吊中胸锁乳突肌源性出血的发生率、分布及其与套索位置结的关系,并根据受试者的主要人体测量特征评估其发生情况。对126例自杀性上吊进行回顾性研究。收集受试者的年龄、体重、身高、甲状腺舌骨骨和颈椎骨折、SCM肌源性出血的存在和分布等资料。采用描述性统计方法,比较典型与非典型悬挂、前悬挂与侧悬挂、左悬挂与右悬挂的特征,分析SCM肌源性出血在结位上的分布。中位年龄55岁(17-94岁),体重70.0 kg(40-125岁),身高176.0 cm(145-205岁)。出血108例(85.7%)。双侧出血以前结位最常见(5 / 7,71.4%),其次为后结位(33 / 53.2%)。单侧SCM肌源性出血最常见于侧结位置(N = 20, 35.1%)。在侧挂中,左侧SCM肌源性出血(aOR = 5.76, 95% CI 1.64-20.19)和右侧SCM肌源性出血缺失(aOR = 6.06, 95% CI 1.48-24.78)与左侧结显著相关。体重(≥67.5 kg)是这些出血的重要预测因子(AUC = 0.639, p
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