title: Causes of death determined in medicolegal investigations in residents of nursing homes: a systematic review.
abstract: OBJECTIVE
  To systematically review published research characterizing the nature and circumstances surrounding the death of older people in nursing homes specifically using information generated for medicolegal death investigations.
  
  
  METHODS
  Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement using the key words death, nursing homes, and medicolegal death investigation.
  
  
  METHODS
  Cross-sectional data from original, peer-reviewed articles published in English between 2000 and 2013 describing deaths of nursing home residents.
  
  
  METHODS
  Information was extracted for analysis about study and population characteristics, number and type of deaths, study design, findings, and limitations.
  
  
  RESULTS
  Thirteen studies were identified. The studies examined external causes of deaths from suicide, choking, restraint or bed-related injuries, falls, and pressure injuries. Deaths were more frequent in women with existing comorbidities. Suicide was predominant in men. Identified risk factors and opportunities to reduce harm were identified at individual, organizational, and structural levels. Overall, the quality of the studies limited the aggregation and comparability of findings.
  
  
  CONCLUSIONS
  This systematic review informs researchers, clinicians and policy-makers about how to reduce external causes of death in nursing homes.
authors.affiliation: Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Briohny
authors.initials: B
authors.lastname: Kennedy
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Ibrahim
authors.forename: Lyndal
authors.initials: L
authors.lastname: Bugeja
authors.forename: David
authors.initials: D
authors.lastname: Ranson
mesh_terms: D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012307:Risk Factors; D012737:Sex Factors
keywords: coroners and medical examiners; death; medicolegal investigation; nursing homes