Retrospective study on solitary deaths (kodoku-shi) from the aspects of forensic and social medicine

IF 1.4 4区医学 Q3 MEDICINE, LEGAL

Legal Medicine Pub Date : 2025-09-20 DOI:10.1016/j.legalmed.2025.102712

Yumiko Hashizume, Akiko Ishigami, Yuko Ishida, Mizuho Nosaka, Yumi Kuninaka, Hiroki Yamamoto, Satoshi Hata, Jumpei Matsuki, Haruki Yasuda, Tatsunori Takayasu, Fukumi Furukawa, Akihiko Kimura, Toshikazu Kondo

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Abstract

This retrospective study evaluated 637 forensic autopsy cases of solitary deaths (kodoku-shi in Japanese) and clarified the current status of solitary deaths from the viewpoint of forensic medicine. Of the 637 cases of solitary death, 471 were men and 166 were women, indicating that solitary death predominantly occurred in men. This tendency increased from the age of 40 years in men to 60 years in women. Among these, 349 and 199 were natural and external deaths, respectively. Ischemic heart disease and fire-related fatalities were the most common causes of natural and external death, respectively. Suicidal deaths were more frequent among women than men. We found two peaks of postmortem interval until finding (PMI-f): <1 day (182 cases, 28.6 %) and 7 days to < 1 month (164 cases, 25.7 %). The PMI-f was significantly shorter in women than in men. The PMI-f of external death cases was significantly shorter than that of natural death cases. Kushimoto and Shingu, located in Southern Japan (Kinan region), had a high solitary death rate in forensic autopsy cases because of the high aging rate and high rate of individuals in single-person households aged ≥ 65 years. Few cases of solitary deaths in the Kinan region (non-urban area) were welfare recipients, and 23 of the 36 welfare recipients lived in Wakayama City, indicating that the economic state contributed more to the occurrence of solitary deaths in Wakayama City (urban area). We identified several risk factors and regional characteristics of solitary deaths. Our observations could contribute to administrative welfare measures for the prevention of solitary deaths.

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从法医学和社会医学角度对孤独死亡进行回顾性研究。

本研究回顾性分析了637例单独死亡的法医尸检案例，从法医学角度阐明了目前单独死亡的现状。在637例单独死亡中，471例为男性，166例为女性，表明单独死亡主要发生在男性中。这种趋势在男性40岁到女性60岁之间增加。其中自然死亡349人，外部死亡199人。缺血性心脏病和火灾相关死亡分别是自然死亡和外部死亡的最常见原因。自杀死亡在女性中比男性更常见。我们发现在发现前的死后时间间隔有两个峰值（PMI-f）：

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Legal Medicine Nursing-Issues, Ethics and Legal Aspects

CiteScore

2.80

自引率

6.70%

发文量

119

审稿时长

7.9 weeks

期刊介绍： Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.