Prevalence and analysis of Amussat’s, Martin’s and Simon’s signs in suicide by hanging in socio-demographic context in the Poznan metropolitan area and surrounding provinces in Poland in 2007–2022

Hanging is the most common method of suicide worldwide and is characterized by a high mortality rate. The purpose of this study is to determine the incidence of Martin’s, Amussat’s, and Simon’s signs in hanging cases and to investigate the epidemiology of suicide by hanging. Amussat’s sign is a transverse laceration of the intimal layer of carotid arteries, Martin’s sign is definied as a hematoma in the adventitia of the carotid artery and Simon’s sign is a haemorrhage into the anterior surface of the intervertebral discs of the lumbar region. Study analyzed 6072 autopsy protocols performed between 2007 and 2022 in the Department of Forensic Medicine of Poznan University of Medical Sciences, of which 367 were cases of suicide by hanging, that meet the inclusion criteria. The analysis took into account: age, gender, place of death, month and year of death, and presence of typical post-mortem signs of hanging. In this study, there was no clear trend in mortality due to suicides by hanging. Men more often committed suicide by hanging than women (84,7%). The average age is 44 years. The results suggest that in more than half of the deaths resulting from suicide hangings, the postmortem examination did not reveal any of the three symptoms studied, and Simon’s sign is the most common. Simon’s symptom occurred more frequently among younger people and men. Moreover, Simon’s sign was more often identified in cases revealed in the public space in summer.