title: Drug- and alcohol-related deaths at a pediatric institution in the United kingdom.
abstract: OBJECTIVE
  The study aimed to identify the incidence, clinical presentation, and demographic features of drug- and alcohol-related deaths diagnosed at a pediatric pathology department between 2004 and 2010.
  
  
  METHODS
  Databases of the histopathology and toxicology departments were searched. Three groups were defined as follows: (1) cause of death is toxicologically related; (2) drugs present are consistent with therapeutic range use; and (3) a drug was detected, but the contribution of this drug to the mechanism of death was not clear.
  
  
  RESULTS
  Fifty-five cases (36 males, 19 females; mean, 4.8 years; range, 2 hours to 17 years) were identified. This corresponded to 3.3% (55/1669) of all postmortems. Ten cases were group 1, 42 cases were group 2, and 3 cases were group 3. The results in group 1 were methadone (n = 2); methadone, alcohol, and dothiepin (n = 1); diazepam (n = 1); dothiepin (n = 1); carbon monoxide (n = 2); tramadol (n = 1); codeine and paracetamol (n = 1); and dihydrocodeine, citalopram, amitriptyline, and paracetamol (n = 1). The types of death were considered accidental (n = 2), suicide (n = 2), and undetermined (n = 6).
  
  
  CONCLUSIONS
  The presence of a toxin in lethal concentration was found in 10 (0.6%) of 1669 of any kind of postmortem examinations. This increased to 2.2% when the analysis was restricted to "sudden deaths." These results demonstrate the need to conduct toxicological screening in all postmortems of this sort.
authors: Department of Clinical Chemistry, Sheffield Teaching Hospital, Sheffield, United Kingdom.
authors: Stephen R
authors: SR
authors: Morley
authors: Julia
authors: J
authors: Becker
authors: Mudher
authors: M
authors: Al-Adnani
authors: Marta Cecilia
authors: MC
authors: Cohen
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D002249:Carbon Monoxide Poisoning / Q000401:mortality; D002492:Central Nervous System Depressants / Q000009:adverse effects* / Q000506:poisoning; D002648:Child; D002675:Child, Preschool; D002853:Chromatography, Liquid; D064420:Drug-Related Side Effects and Adverse Reactions; D000431:Ethanol / Q000009:adverse effects* / Q000506:poisoning; D005260:Female; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D009294:Narcotics / Q000009:adverse effects* / Q000506:poisoning; D010337:Pathology Department, Hospital; D011041:Poisoning / Q000401:mortality*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D013405:Suicide / Q000706:statistics & numerical data; D006113:United Kingdom
chemical_list: D002492:Central Nervous System Depressants; D009294:Narcotics; D000431:Ethanol