Postmortem clots (PMC) of the heart; is it merely an artifact or a predictor of cause of death?

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL

Ceylon Medical Journal Pub Date : 2022-11-30 DOI:10.4038/cmj.v67i3.9693

Senanayake Kumara, Amerasinghe Ishanka, Warnasekara Janith

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引用次数: 0

Abstract

Background: Post Mortem Clots (PMC) are considered as artifacts observed during forensic autopsies; hence, their medico legal importance has not been evaluated at length in the past. This study was designed with the intent of finding the association of age, gender, cause of death (COD) and postmortem interval (PI) with PMC formation.

Methods: Secondary data of all postmortems performed by the 1st author from June,2015 to June,2018 at Teaching Hospital Anuradhapura were extracted. Eligible autopsies were evaluated for the presence of PMCs in the heart. Length of the PMCs present was quantified as a percentage of the length of the cardiac chambers. Presence of PMCs varied according to the COD which were clustered based on their mechanism of death.

Results: The study evaluated 1259 autopsies with a median age of 56 years (IQR 40-67). PMCs were found in 46% of the subjects and showed a female predominance. The percentage of length of PMCs ranged from 20% to 100%. A higher rate of PMC formation was observed in natural and infectious causes, especially in the elderly. Traumatic causes with multiple injuries, heavy bleeding and a short agonal period showed less tendency of PMC formation. A higher duration of hospital stay/injury to death (> 90 h) was associated with formation of PMC. PMC is not associated with PI while it's associated with increased age.

Conclusion: PMC is not a mere artifact but has significant medicolegal importance with regards to COD and time from injury to death.

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心脏死后血栓（PMC）；它仅仅是一个假象还是死亡原因的预测因素？

背景：死后凝块（PMC）被认为是在法医尸检中观察到的人工制品；因此，它们在医学法律上的重要性在过去没有得到详细的评估。本研究旨在寻找年龄、性别、死因（COD）和死后间隔（PI）与PMC形成的关系。方法：提取第一作者于2015年6月至2018年6月在Anuradhapura教学医院进行的所有尸检的次要数据。对符合条件的尸检进行评估，以确定心脏中是否存在PMCs。存在的PMCs的长度被量化为心室长度的百分比。PMCs的存在根据COD而变化，根据其死亡机制进行聚类。结果：该研究评估了1259例尸检，中位年龄为56岁（IQR 40-67）。在46%的受试者中发现了PMCs，并显示出女性占主导地位。PMCs的长度百分比在20%到100%之间。在自然和感染原因中观察到PMC形成率较高，尤其是在老年人中。多处损伤、大出血和短阵痛期的创伤原因显示PMC形成的趋势较小。住院时间/损伤致死时间越长（>90小时），PMC的形成越明显。PMC与PI无关，但与年龄增加有关。结论：PMC不仅仅是一个人工制品，而且在COD和从损伤到死亡的时间方面具有重要的法医学意义。

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

Ceylon Medical Journal MEDICINE, GENERAL & INTERNAL-

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期刊介绍： The Ceylon Medical Journal, is the oldest surviving medical journal in Australasia. It is the only medical journal in Sri Lanka that is listed in the Index Medicus. The CMJ started life way back in 1887 as the organ of the Ceylon Branch of the British Medical Association. Except for a brief period between 1893 and 1904 when it ceased publication, the CMJ or its forbear, the Journal of the Ceylon Branch of the British Medical Association, has been published without interruption up to now. The journal"s name changed to the CMJ in 1954.