Influence of cause of death and blood ethanol concentration on the coagulability of cadaveric blood.
It is well-known that cadaveric blood tends to retain their fluidity in acute deaths. However, our experience indicated that blood clots are occasionally seen in such cases, especially with antemortem consumption of ethanol. We reviewed autopsy reports from 2001 to 2006 in our division retrospectively. We made evaluations of blood coagulability based on the descriptions in the autopsy reports, and classified them into three categories; "none", "some amount of clot", and "large amount of clot". Out of 782 cases except for putrefactive or charred bodies, 202 cases showed coagulation of heart bloods. Among them, large amount of clots were observed in 140 cases, in which the cause of death included so-called slow deaths such as hypothermia, infections and in-hospital deaths. Additionally, some reputed acute deaths exhibited large amount of clots; fire death (18 cases), drowning (17 cases), other types of asphyxia (5 cases) and cardiac deaths (9 cases). We adopted 0.1 mg/ml of blood ethanol concentration (BEC) as a cut off value, and a correlation of blood coagulability and BEC was tested with chi-square test. With exclusion of slow deaths, the number of cases with blood clot was significantly higher in cases with positive BEC (180 cases) than those with negative BEC (367 cases) (p=0.000085). However, after raising cut off value of BEC (>1.0 mg/ml), the p value was elevated (p=0.00066). Based on this study, we considered that postmortem blood coagulability was influenced not only by simple pharmacodynamic actions of ethanol but also by other factors including coexisting pathological conditions.
Takahashi
Shirushi
S
Division of Forensic Medicine, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. shirushi@forensic.med.tohoku.ac.jp
Sakai
Jun
J
Hashiyada
Masaki
M
Funayama
Masato
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001237:Asphyxia / Q000097:blood; D001777:Blood Coagulation; D002056:Burns / Q000097:blood; D002102:Cadaver; D002318:Cardiovascular Diseases / Q000097:blood; D002492:Central Nervous System Depressants / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D016883:Diabetic Ketoacidosis / Q000097:blood; D004332:Drowning / Q000097:blood; D000431:Ethanol / Q000097:blood*; D005260:Female; D005390:Fires; D049429:Forensic Pathology; D006801:Humans; D007035:Hypothermia / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000097:blood; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000097:blood; D055815:Young Adult
D002492:Central Nervous System Depressants; D000431:Ethanol