Application of the drowning index to actual drowning cases.
The drowning index (DI) was devised to diagnose drowning deaths, and is the weight ratio of the lungs and pleural effusion to the spleen. Among drowning (94 cases), mechanical asphyxia (47 cases), and acute cardiac (42 cases) deaths, within 2 weeks postmortem we compared six markers, the weight of each lung, pleural effusion weight, total weight of the lungs and pleural effusion, spleen weight, heart weight, and the DI. Statistical analysis revealed that the total weight was heavier, while spleen weight was lighter, and the DI was significantly larger in the drowning group (p<0.05). We examined the relation between the postmortem time and these markers. We divided 94 drowning cases into three groups according to the postmortem duration, group A (0-3 days; 43 cases), group B (3-7; 29 cases), and group C (7-14; 22 cases). The cut-off point of the DI was analyzed using the receiver operating characteristic (ROC) curve. As a result, the DI cut-off point was 14.1 in cases within two postmortem weeks. Drowning is still a difficult autopsy diagnosis, but in our experience, DI is a valuable indicator.
Sugimura
Tomoko
T
Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Kashiwagi
Masayuki
M
Matsusue
Aya
A
Hara
Kenji
K
Kageura
Mitsuyoshi
M
Kubo
Shin-ichi
S
D000368:Aged; D001237:Asphyxia / Q000401:mortality / Q000473:pathology; D001344:Autopsy / Q000379:methods; D002423:Cause of Death; D004332:Drowning / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000473:pathology; D007564:Japan / Q000453:epidemiology; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000473:pathology; D010996:Pleural Effusion / Q000473:pathology; D012372:ROC Curve