FEATURES OF DIAGNOSTICS OF FATAL KIDNEY INJURY IN MEDICAL PRACTICE.

Abstract

Aim: To examine how temperature changes over time in injured and uninjured kidney tissues, based on the time elapsed since trauma and death. Additionally, develop a regression model to estimate the time of death using temperature measurements from the abdominal organs.

Material and methods: The study included data from 256 individuals (both males and females aged 20-60 years) who died from mechanical trauma. Tissue temperatures were measured using infrared thermometry at various times within 24 hours after death. The analysis covered temperature measurements of the liver, spleen, pancreas, kidneys, skin, and the thickness of subcutaneous fat tissue.

Results: Determining the exact time of death remains a complex aspect of forensic practice, especially in cases involving traumatic injuries. Often, the moment of injury does not match the time of death: the person may die immediately at the scene or after some delay-during transport or at a medical facility. Therefore, distinguishing between the "time of injury" and the "time of death" is crucial for accurate forensic evaluation. A statistically significant decrease in temperature was observed in both injured and uninjured kidney tissues. The temperature in the injured areas stayed consistently higher by 2-3 °C (±0.28) compared to uninjured regions. The temperature difference between the right and left kidneys was 1.5-2 °C (±0.14), likely due to anatomical factors that offer greater protection to the right kidney. The sex of the deceased did not affect temperature indicators. A regression model was created to estimate the time of death with high accuracy (R² = 0.86), including temperatures of several parenchymal organs, skin temperature, subcutaneous fat thickness, and ambient temperature. All predictors in the model were statistically significant (p<0.05).

Conclusions: The developed multivariate regression model, which considers temperature parameters of injured and uninjured parenchymal organs, serves as a promising tool for forensic estimation of the time of death. Our study's findings emphasize the potential of infrared thermometry in forensic practice as a quantitative method for determining the post-injury interval and the time of death.