调查 2016-2020 年间爱尔兰发生的绞刑和徒手/凶器勒死案件中颈部损伤的模式和毒理学的作用:回顾与分析

IF 1.2 4区 医学 Q3 MEDICINE, LEGAL
Corey Commins , Margot Bolster , Linda Mulligan
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引用次数: 0

摘要

在尸检(PME)过程中,会记录颈部受到外部挤压致死案件中的颈部损伤模式,以帮助解释导致死亡的情况。在本研究中,我们对2016年至2020年间发生在爱尔兰的298起绞刑和勒死案件的尸检进行了回顾性审查,目的是记录和整理每次尸检中观察到的颈部外部和内部损伤,以及每位死者的毒理学结果。进行统计分析的目的是调查与死者有关的人体测量变量与上吊和勒死案件中的初步颅脑损伤检查结果之间可能存在的新关联,从而为该领域的现有研究提供更多数据,并协助解决今后出现结论冲突的上吊或勒死案件。在完成统计分析后发现,软骨颈骨折(CNF)的发生率与结扎宽度的增加之间没有明显的关联。研究发现,死者体重和体重指数的增加与软骨颈骨折的发生率呈正相关,死者身高的增加与软骨颈骨折的发生率呈显著正相关。毒理学分析表明,在与 CNFs 相关的不完全和完全悬吊病例中,抗精神病药物最为常见,而在与 CNFs 相关的徒手扼颈和结扎扼颈病例中,阿片类药物最为常见。目的记录在回顾性上吊和徒手/结扎勒死案件中颈部受伤的模式,并整理这些结果,以便为今后的自杀性上吊和他杀性徒手/结扎勒死案件中对调查结果的解释提供科学依据,从而达到医学法律调查的目的。研究设计回顾性审查了 2016 年至 2020 年期间爱尔兰对 298 例上吊和徒手/凶杀勒颈案件进行的尸检(PME)报告。每份报告都记录了伪匿名数据集,其中包括以下参数:颈部损伤(软组织和软骨)、体重、身高、体重指数和结扎宽度、毒理学、绳套位置、结扎材料、舌头突出、性别和年龄。这些数据的使用已征得病理学家和验尸官的同意。结果通过逻辑回归分析,研究了结扎宽度的单位增长与死者一系列身体特征(体重、体重指数和身高)的增长与 CNFs 发生率之间的关系。研究发现,增加结扎宽度并不会增加发生 CNF 的可能性,其发生率为 0.9596。单位体重和体重指数的增加会增加发生 CNF 的可能性,OR 分别为 1.0166 和 1.0607。结论根据本研究的统计分析,体重、身高和体重指数的增加会增加完全上吊病例中发生 CNF 的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
To investigate the pattern of neck injuries and the role of toxicology in cases of hanging and manual/homicidal ligature strangulation in Ireland between 2016 – 2020: A retrospective review and analysis

The pattern of neck injuries sustained in fatal cases of external compression to the neck is recorded during Post Mortem Examinations (PME), to assist in the interpretation of the circumstances that led to death. In this study, the PMEs performed for 298 cases of hanging and strangulation occurring between 2016 and 2020 in Ireland were retrospectively reviewed for the purpose of recording and collating the external and internal neck injuries observed during each PME, as well as the toxicology results for each decedent. Statistical analysis was performed to investigate potential novel associations between anthropometric variables pertaining to the decedents and the PME findings in cases of hanging and strangulation, serving to add further data to the existing body of research in this area and to assist in the resolution of future cases of hanging or strangulation where there are conflicting findings. In completing statistical analysis, it was found that there was no discernible association between the occurrences of cartilaginous neck fractures (CNFs) with increasing ligature width. Positive associations between increasing weight and BMI of the decedents were identified, and a significantly positive association between the increasing height of the decedent and the incidence of CNFs were identified. Analysis of the toxicology demonstrated that antipsychotics were implicated most frequently in cases of incomplete and complete hanging associated with CNFs and that opioids were implicated most frequently in cases of manual and ligature strangulation associated with CNFs.

Objective

To record the pattern of neck injuries sustained in retrospective cases of hanging and manual/ligature strangulation and to collate these findings so as to provide scientific evidence to support the interpretation of the findings in future cases of suicidal hanging and homicidal manual/ligature strangulation for the purpose of medicolegal investigation. To analyse the associations between the occurrence of neck fractures and anthropometric variables pertaining to the victims in cases of complete hanging.

Study design

The reports of 298 Post Mortem Examinations (PMEs) performed for cases of hanging and manual/homicidal ligature strangulation between 2016 and 2020 in Ireland were retrospectively reviewed. Pseudoanonymised data sets were recorded for each report, which included the following parameters: neck injuries (soft tissue and cartilaginous), weight, height, BMI and ligature width, toxicology, noose position, ligature material, tongue protrusion, sex and age. Permission for the use of this data was sought from the pathologists and coroners involved in these cases. The data was analysed according to descriptive statistical methods and logistic regression analysis.

Results

Logistic regression analysis was undertaken to examine the associations between unit increases in ligature width and increases in a set of physical characteristics of the decedents (weight, BMI and height) with the occurrence of CNFs. Increasing ligature width was not found to increase the likelihood of a CNF occurring, where the Odds Ratio (OR) for this event occurring was 0.9596. Unit increases in body weight and BMI were found to increase the likelihood of the occurrence of a CNF with ORs of 1.0166 and 1.0607 respectively. Increasing height of the decedent yielded an OR = 4.64, demonstrating that CNFs are significantly more likely to occur with increasing height (CI 95 %: 0.2915, 73.9559).

Conclusions

According to the statistical analysis performed for this study, increasing weight, height and BMI are parameters of the decedents which increase the likelihood of the occurrence of CNFs in cases of complete hanging.

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来源期刊
CiteScore
2.70
自引率
6.70%
发文量
106
审稿时长
57 days
期刊介绍: The Journal of Forensic and Legal Medicine publishes topical articles on aspects of forensic and legal medicine. Specifically the Journal supports research that explores the medical principles of care and forensic assessment of individuals, whether adult or child, in contact with the judicial system. It is a fully peer-review hybrid journal with a broad international perspective. The Journal accepts submissions of original research, review articles, and pertinent case studies, editorials, and commentaries in relevant areas of Forensic and Legal Medicine, Context of Practice, and Education and Training. The Journal adheres to strict publication ethical guidelines, and actively supports a culture of inclusive and representative publication.
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