Blood acetone concentrations in forensic autopsies are related to the food residue in stomach

Abstract

Elevated blood acetone concentrations are used as an initial marker to identify ketoacidosis in forensic autopsies. However, blood acetone concentrations may not reflect the status of ketoacidosis. This study aimed to clarify the significance of measuring blood acetone concentrations in routine forensic autopsies. We studied 367 forensic autopsies to determine the relationships between blood acetone concentrations and blood ethanol concentrations, blood biochemical laboratory test values, as well as the physical factors that may affect blood acetone concentrations. Blood acetone concentrations showed no correlations with blood ethanol concentrations, blood HbA1c levels, blood C-reactive protein levels, amount of gastric content, and body mass index. Blood acetone concentrations were significantly higher in subjects without residual food in their stomach. Binomial logistic regression analysis revealed that the increase in blood acetone concentrations was significantly associated with the absence of gastric residue. Our findings indicated that increased blood acetone concentrations were related to the absence of food residues in the stomach at the time of death. In forensic autopsy cases with elevated blood acetone concentrations, the presence or absence of residual food in the stomach should be considered.