Journal of forensic and legal medicine最新文献

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A case report on the reconstruction of arson, corpse burning, and postmortem relocation based on burn trace characteristics 基于烧痕特征的纵火案、焚尸案及尸后安置重构案例报告
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-09-02 DOI: 10.1016/j.jflm.2025.102965
Xiaotong Wang , Jing Jin , Gang Wang , Jinzhuan Zhang
{"title":"A case report on the reconstruction of arson, corpse burning, and postmortem relocation based on burn trace characteristics","authors":"Xiaotong Wang ,&nbsp;Jing Jin ,&nbsp;Gang Wang ,&nbsp;Jinzhuan Zhang","doi":"10.1016/j.jflm.2025.102965","DOIUrl":"10.1016/j.jflm.2025.102965","url":null,"abstract":"<div><div>Forensic identification at fire scenes faces three core challenges: distinguishing cause of death (antemortem burning versus postmortem corpse burning), reconstructing criminal behavior (arson versus accident), and preserving evidence (thermal destruction versus artificial tampering). This case study systematically demonstrates the application value of burn trace characteristics in arson investigation through a typical intentional homicide and corpse burning case. Based on a three-dimensional analytical framework of human burn-behavioral characteristics, a systematic pathway incorporating reconstruction of arson/corpse burning processes and identification of body relocation behavior was established. For arson reconstruction, spatial mapping relationships formed between the suspect's clothing charring gradients and bodily burn distribution, enabling reconstruction of the ignition sequence (left-hand ignition source → left-leaning ignition → exit path reconstruction) through integration with left-handed behavioral traits; this kinematic trajectory exhibits complete behavioral-burn correspondence with burn morphological distribution patterns. Regarding body relocation identification, critical evidence including absence of transition zones in corpse charring areas, stratigraphic inversion between remains and combustion residues, intact preservation of buttock skin in supine position, and protective preservation characteristics of occipital hair collectively constructed spatiotemporal evidence of relocation. This case interlinks burn morphology and human behavioristics to establish a technical paradigm for reconstructing criminal processes in complex fire scenes, providing a replicable empirical model for solving “corpse burning-evidence destruction” cases.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102965"},"PeriodicalIF":1.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A machine learning approach for automated injuries classification on postmortem images 一种基于死后图像的自动损伤分类机器学习方法
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-09-01 DOI: 10.1016/j.jflm.2025.102955
Kamila Barbara Kalinowska , Dorota Zawieska , Sebastian Puchała , Paweł Krajewski , Marcin Fudalej , Ireneusz Sołtyszewski , Patryk Kot
{"title":"A machine learning approach for automated injuries classification on postmortem images","authors":"Kamila Barbara Kalinowska ,&nbsp;Dorota Zawieska ,&nbsp;Sebastian Puchała ,&nbsp;Paweł Krajewski ,&nbsp;Marcin Fudalej ,&nbsp;Ireneusz Sołtyszewski ,&nbsp;Patryk Kot","doi":"10.1016/j.jflm.2025.102955","DOIUrl":"10.1016/j.jflm.2025.102955","url":null,"abstract":"<div><div>The application of Artificial Intelligence (AI) in forensic science offers new opportunities for the automated detection of injuries in postmortem analysis. This study focuses on the semantic segmentation of two significant types of injuries—bruises and abrasions. A dataset of postmortem injury images was collected, followed by the development of appropriate data preprocessing and annotation techniques to train and evaluate AI models. Three deep learning architectures—U-Net, FPN, and LinkNe—were implemented, using EfficientNetB3 and ResNet50 as backbone networks. An optimisation strategy was employed to enhance detection performance by incorporating a custom loss function alongside a combination of image transformation and class balancing techniques. Experimental results demonstrated high sensitivity (92.7 %) and specificity (98.9 %) for the best-performing model. These findings highlight the potential of AI-driven methods for automated and objective analysis of postmortem images in injury detection, laying the foundation for further research.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102955"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics of alleged sexual assaults involving non-fatal strangulation at a Sydney metropolitan emergency department: a prospective descriptive study 悉尼市区急诊科涉及非致命勒死的性侵犯指控的特征:一项前瞻性描述性研究
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-29 DOI: 10.1016/j.jflm.2025.102967
Rachael Thomas , Kate Willmot , Radhika Seimon , Naomi Derrick , Michael M. Dinh , David J. Templeton
{"title":"Characteristics of alleged sexual assaults involving non-fatal strangulation at a Sydney metropolitan emergency department: a prospective descriptive study","authors":"Rachael Thomas ,&nbsp;Kate Willmot ,&nbsp;Radhika Seimon ,&nbsp;Naomi Derrick ,&nbsp;Michael M. Dinh ,&nbsp;David J. Templeton","doi":"10.1016/j.jflm.2025.102967","DOIUrl":"10.1016/j.jflm.2025.102967","url":null,"abstract":"<div><h3>Background</h3><div>Non-fatal strangulation (NFS) has the potential to cause serious harm and is increasingly common in sexual assault. The incidence may be higher than previously thought, underscoring the importance of screening. The aim of this study was to explore factors related to NFS in sexual assault presentations in a metropolitan Emergency Department (ED) in New South Wales (NSW), Australia.</div></div><div><h3>Methods</h3><div>A prospective review of the Medical and Forensic Examination Record (MFER) was used to retrieve data from patients at a metropolitan ED in NSW, Australia who underwent forensic examination for an alleged sexual assault, who reported NFS, between July 2021 and May 2024. Data were collected on these patients at the time of their review in the ‘NFS Checklist’ as well as the MFER. Parallel electronic medical records (eMR) were used to obtain information collected in the ED.</div></div><div><h3>Results</h3><div>Of 802 sexual assault presentations between July 2021 and May 2024, 113 (14%) cases involved NFS. 105 (92.9%) were female and 72 (63.7%) patients presented with ‘red flags’, the most common being dyspnoea (n = 43, 38.1%). Almost half of all cases (n = 49, 43.4%) had related physical examination findings. Over half (n = 64, 56.6%) of cases were referred to the ED, where 36 images were ordered, of which only one was abnormal. 25.6% of perpetrators were intimate partners.</div></div><div><h3>Conclusion</h3><div>NFS is common in sexual assault. More robust follow-up systems are essential. ED and Sexual Assault Services would benefit from implementing a protocolised triage and referral system which screens for red flags and domestic violence.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102967"},"PeriodicalIF":1.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145044776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reliability of fingerprint experts in extracting and evaluating minutiae in individualization tests of fingerprint traces 指纹专家在指纹痕迹个性化测试中提取和评估细节的可靠性
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-26 DOI: 10.1016/j.jflm.2025.102943
Marta Nawrocka-Świętkowiak , Piotr Banasiak , Jędrzej Wydra
{"title":"Reliability of fingerprint experts in extracting and evaluating minutiae in individualization tests of fingerprint traces","authors":"Marta Nawrocka-Świętkowiak ,&nbsp;Piotr Banasiak ,&nbsp;Jędrzej Wydra","doi":"10.1016/j.jflm.2025.102943","DOIUrl":"10.1016/j.jflm.2025.102943","url":null,"abstract":"<div><div>This study examines the reliability of fingerprint experts in assessing the individualization value of minutiae during the analysis of latent fingerprint traces. Despite the widespread use of fingerprint evidence in criminal investigations, growing concerns about examiner variability and the lack of verification protocols have prompted critical scrutiny of forensic practices. In this study, 30 Polish fingerprint experts were asked to identify and evaluate seven minutiae in two fingerprint traces of differing quality. Experts classified each minutia and rated its individualization value on a five-point scale. Inter-rater reliability was assessed using Krippendorff’s alpha, and the relationship between selection frequency and individualization value was analyzed via linear regression and correlation.</div><div>Results revealed low inter-expert agreement in both minutiae selection and value assessment, with alpha coefficients of 0.39 for the trace of high-quality and 0.42 for the traces of a lower-quality. A strong negative correlation was found between how often a minutia was selected and its perceived individualization value (r = –0.84 for the trace of a high-quality and r = –0.89 for the trace of a lower-quality), suggesting that commonly selected features were viewed as less discriminative. These findings indicate that while experts may converge on general patterns at the group level, their individual assessments are often inconsistent.</div><div>The study underscores the need for systematic verification of expert conclusions. Given the variability observed, relying on a single unverified fingerprint opinion poses a substantial risk of error. Requiring that initial reports be prepared by multiple independent experts could enhance the reliability of conclusions and reduce vulnerability to evidentiary challenges.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102943"},"PeriodicalIF":1.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond the sexual assault: A comprehensive service model for forensic and medical care 超越性侵犯:法医和医疗护理的综合服务模式
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-22 DOI: 10.1016/j.jflm.2025.102956
Vanita Parekh , Janine McMinn , Anna Brkic , Catherine Sansum , Brooke James , Cassandra Noble
{"title":"Beyond the sexual assault: A comprehensive service model for forensic and medical care","authors":"Vanita Parekh ,&nbsp;Janine McMinn ,&nbsp;Anna Brkic ,&nbsp;Catherine Sansum ,&nbsp;Brooke James ,&nbsp;Cassandra Noble","doi":"10.1016/j.jflm.2025.102956","DOIUrl":"10.1016/j.jflm.2025.102956","url":null,"abstract":"<div><h3>Background</h3><div>To describe the characteristics of patients, the elements of medical care, evidence collection and service provision in a forensic medical sexual assault service.</div></div><div><h3>Method</h3><div>A retrospective observational study of 2329 patients aged from 12 years presenting after sexual assault over an 18-year period.</div></div><div><h3>Results</h3><div>Most victims were females of reproductive age. Perpetrators were males in 88 % with single assailants in 80.5 % of cases. Reported alcohol and substances consumed were 53.9 % and 14.2 % of cases respectively. Forensic and medical examination was undertaken in 75.1 %, with forensic evidence collected in 72.2 % and forensic photography in 23.2 %. On-site storage of the medical evidence kit occurred in 61.2 % of cases. Healthcare provision included STI screening (79.4 %), and emergency contraception (33.7 %). Delayed presentation after 7 days occurred in 11.4 % of cases, with over 86 % of cases seen within 7 days of the sexual assault. Most consultations (85 %) took under 3 h, 55.4 % of assessments were callouts out of business hours. Support persons attended the examination in 66.2 % of cases.</div></div><div><h3>Conclusions</h3><div>In a well-resourced setting, both medical and forensic elements of care can and should be provided following sexual assault. However, medical needs must take priority with consideration for the collection of forensic evidence. Some victims present to a medical setting after sexual assault which should minimise barriers to reporting. However, this service should be provided in a DNA minimal clinical space, by forensically trained clinicians ideally in an Emergency Department. Data collection and analysis are critical in auditing for continual service improvement.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102956"},"PeriodicalIF":1.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sudden death associated with primary leptomeningeal melanocytosis without features of neurocutaneous melanosis syndrome 猝死与原发性小脑膜黑素细胞增多症相关,无神经皮肤黑素病综合征特征
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-22 DOI: 10.1016/j.jflm.2025.102953
Mehmet Doğan , Aytül Buğra , Ferah Karayel , İbrahim Üzün
{"title":"Sudden death associated with primary leptomeningeal melanocytosis without features of neurocutaneous melanosis syndrome","authors":"Mehmet Doğan ,&nbsp;Aytül Buğra ,&nbsp;Ferah Karayel ,&nbsp;İbrahim Üzün","doi":"10.1016/j.jflm.2025.102953","DOIUrl":"10.1016/j.jflm.2025.102953","url":null,"abstract":"<div><h3>Background</h3><div>Leptomeningeal melanocytosis is a rare, benign melanocytic proliferation of the central nervous system, typically associated with neurocutaneous melanosis. Isolated forms without cutaneous involvement are extremely uncommon, especially in adults, and pose significant diagnostic and medicolegal challenges.</div></div><div><h3>Case report</h3><div>We report the sudden death of a 29-year-old man with no known medical history, found unresponsive in a prone position. External examination revealed no traumatic injuries, and toxicology was negative. Gross and microscopic examination of the brain demonstrated diffuse leptomeningeal melanocytic infiltration over the frontotemporoparietal cortex and cerebellum. Histologically, the lesion was composed of bland melanocytes containing fine melanin pigment without mitotic activity or atypia. No primary or metastatic melanoma was identified elsewhere in the body. The findings were consistent with primary diffuse leptomeningeal melanocytosis.</div></div><div><h3>Discussion</h3><div>Although histologically benign, leptomeningeal melanocytosis may affect critical CNS regions, potentially leading to seizures, autonomic dysregulation, or sudden death. This case emphasizes the importance of thorough neuropathological investigation in unexplained deaths. The location and extent of melanocytic infiltration suggest a possible seizure-related terminal event, highlighting a rare but important differential diagnosis in forensic practice.</div></div><div><h3>Conclusion</h3><div>This case underscores the forensic significance of isolated primary leptomeningeal melanocytosis as a potential cause of sudden death. Early recognition of this rare entity requires a combination of detailed autopsy, histopathology, and awareness of its variable clinical presentations, especially in the absence of cutaneous signs. These findings are of particular relevance to forensic pathologists investigating sudden, unexplained deaths.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102953"},"PeriodicalIF":1.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiological, forensic, and clinical insights into burn injuries: A decade-long retrospective analysis from Goa Medical College 烧伤的流行病学、法医和临床见解:果阿医学院十年来的回顾性分析
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-22 DOI: 10.1016/j.jflm.2025.102954
Sweta Nidhi , Chetan.L. Karekar , Lekshmi Ramesh , Sruthi B. , R.S. Adithiyan , Abhishek Singh
{"title":"Epidemiological, forensic, and clinical insights into burn injuries: A decade-long retrospective analysis from Goa Medical College","authors":"Sweta Nidhi ,&nbsp;Chetan.L. Karekar ,&nbsp;Lekshmi Ramesh ,&nbsp;Sruthi B. ,&nbsp;R.S. Adithiyan ,&nbsp;Abhishek Singh","doi":"10.1016/j.jflm.2025.102954","DOIUrl":"10.1016/j.jflm.2025.102954","url":null,"abstract":"<div><div>Burn injuries constitute a significant public health and forensic challenge, accounting for 8.91 % of total post-mortem examinations in Goa during 2014–2023. This study examines 972 burn cases, analysing epidemiological, forensic, and clinical factors. Key findings include a high prevalence of burns among married individuals, middle socioeconomic classes, and females exposed to domestic hazards. Suicidal burns accounted for the majority (56.48 %) of cases, with septic shock being the leading cause of death. Principal component analysis (PCA) revealed significant correlations between types of burns, microbial infections, survival rates, and socioeconomic factors. The study underscores the need for targeted public health interventions, improved forensic protocols, and mental health support to reduce burn-related mortality.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102954"},"PeriodicalIF":1.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meningioma: A silent cause of suicide -case study 脑膜瘤:一个沉默的自杀原因-个案研究
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-21 DOI: 10.1016/j.jflm.2025.102957
Rahul Panwar , Meena Suresh Kumar , Devendra Jadav , Abhishek Purohit , Tanuj Kanchan
{"title":"Meningioma: A silent cause of suicide -case study","authors":"Rahul Panwar ,&nbsp;Meena Suresh Kumar ,&nbsp;Devendra Jadav ,&nbsp;Abhishek Purohit ,&nbsp;Tanuj Kanchan","doi":"10.1016/j.jflm.2025.102957","DOIUrl":"10.1016/j.jflm.2025.102957","url":null,"abstract":"<div><div>This case study explores the incidental discovery of meningiomas in two adult females who died following suicide by poisoning. A history of generalized seizures, depression, and multiple suicidal attempts was present in both cases. In each of the cases, apart from the findings of poisoning, the autopsy revealed a lobular tumour covering the parasagittal area and suprasellar region and compressing the underlying brain matter. The histopathology reports of both cases revealed the mass as a meningioma. The possible association between meningiomas, depression, and suicide has been discussed in the case report. This case report also emphasises the need for autopsies in unravelling the risk factors and the intricacies of suicide-related behaviour.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102957"},"PeriodicalIF":1.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Traumatic in-cerebration due to conveyor machine accident - A distinctive injury pattern case report 传送带机械事故所致的创伤性脑内损伤——一例独特的损伤模式病例报告
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-20 DOI: 10.1016/j.jflm.2025.102952
Pooja Gupta , A. Varun Chandran , K. Karthi Vignesh Raj , D.N. Bhardwaj
{"title":"Traumatic in-cerebration due to conveyor machine accident - A distinctive injury pattern case report","authors":"Pooja Gupta ,&nbsp;A. Varun Chandran ,&nbsp;K. Karthi Vignesh Raj ,&nbsp;D.N. Bhardwaj","doi":"10.1016/j.jflm.2025.102952","DOIUrl":"10.1016/j.jflm.2025.102952","url":null,"abstract":"<div><div>Cranio-cerebral trauma due to crush injury is a commonly encountered cause of death in forensic practice. These mostly occur due to static loading of the head and often present as compound comminuted skull fractures with brain parenchyma extruding out of the body. In the present case, the head crushing injury occurred due to machine entrapment while the conveyor system continued to be operational. This resulted in cranio-caudal migration of the brain matter into the respiratory and gastro-intestinal tracts due to the combined normal compression, translational shear and rotational traction forces acting on the head. This unique ‘traumatic in-cerebration’ injury is being reported here to discuss the role of injury pattern analysis in retrospective event reconstruction and to highlight the importance of conveyor safety practices in industrial workplaces.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102952"},"PeriodicalIF":1.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparing the diagnostic utility of the Pleural Effusion Ratio and the Drowning Index in identifying freshwater drowning deaths 比较胸腔积液比和溺水指数在识别淡水溺水死亡中的诊断效用
IF 1.2 4区 医学
Journal of forensic and legal medicine Pub Date : 2025-08-13 DOI: 10.1016/j.jflm.2025.102950
Nirmal Nagar , Binaya Kumar Bastia , Dipen Dabhi , Yatiraj Singi , Jasmine Jain
{"title":"Comparing the diagnostic utility of the Pleural Effusion Ratio and the Drowning Index in identifying freshwater drowning deaths","authors":"Nirmal Nagar ,&nbsp;Binaya Kumar Bastia ,&nbsp;Dipen Dabhi ,&nbsp;Yatiraj Singi ,&nbsp;Jasmine Jain","doi":"10.1016/j.jflm.2025.102950","DOIUrl":"10.1016/j.jflm.2025.102950","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing drowning during post-mortem examination remains a challenging task due to the absence of any pathognomonic autopsy findings. Recent approaches have proposed quantitative indices, such as the Pleural Effusion Ratio (PE Ratio) and the Drowning Index (DI), to enhance diagnostic accuracy. The PE Ratio is defined as the weight of the pleural effusion divided by the combined weight of the pleural effusion and lungs, multiplied by 100. The DI is defined as the sum of the lung weight and pleural effusion weight, divided by the spleen weight.</div></div><div><h3>Methods</h3><div>This prospective cross-sectional autopsy study evaluated 179 medico-legal cases, comprising 75 freshwater drowning cases, 64 sudden cardiac deaths, and 40 hangings. All drowning incidents occurred in a glacier-fed river under uniform environmental conditions. The PE Ratio and DI were calculated using organ and pleural effusion weights. Statistical analysis included ANOVA, Kruskal–Wallis tests, post hoc testing, and Receiver Operating Characteristic (ROC) curve analysis.</div></div><div><h3>Results</h3><div>The PE Ratio showed a mean value of 29.57 in drowning cases and demonstrated perfect diagnostic performance, with an AUC of 1.0, achieving 100 % sensitivity and specificity at a cut-off value of &gt;7.4. The DI also showed a significant elevation in drowning cases (mean: 14.8) compared to controls, yielding an AUC of 0.828, with 86.7 % sensitivity and 70.2 % specificity at a cut-off value of &gt;9.7.</div></div><div><h3>Conclusion</h3><div>The PE Ratio is a simple, robust, and highly accurate tool for diagnosing freshwater drowning. Although the DI is slightly less specific, it provides valuable complementary information, particularly in cases where pleural fluid assessment is limited.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"115 ","pages":"Article 102950"},"PeriodicalIF":1.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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