title: Child homicide victims in forensic autopsy in Taiwan: A 10-year retrospective study.
abstract: BACKGROUND
  Child homicides are critical medico-legal issues worldwide. Data on the characteristics of these cases in Asia are limited. This study aimed to describe the characteristics of child homicides in Taiwan.
  
  
  METHODS
  A retrospective analysis of forensic autopsy records of child homicide victims (aged 0-17 years) in Taiwan, during a 10-year period between 2001 and 2010, was carried out. The age, sex, relationship with the perpetrator(s), injury patterns of the victims, and causes of death were analyzed.
  
  
  RESULTS
  In all, 193 child homicide autopsies were identified. There were 38 (19.7%), 82 (42.5%), 25 (13.0%), and 48 (24.9%) homicide victims aged under 1, 1-5, 6-12, and 13-17 years, respectively. One-hundred boys (mean age: 8.4±7.0) and 93 girls (mean age: 3.7±4.3) were included. A female predominance was noted among the victims aged 0-5. Blunt force (53.4%) was the most frequent method of injury, followed by suffocation/strangulation (20.2%) and sharp force (13.0%). Bruise (64.8%) and brain injury (45.1%) were the most common types of injuries. The cranium (62.2%) and face (60.6%) were the most frequently injured body regions. The distribution of fatal injuries varied among victims in different age groups. Neurogenic shock, asphyxia, and hemorrhagic shocks were most common in victims aged 0-5, 6-12, and 13-17, respectively. The most frequent causes of death included blunt force head injury (40.4%), suffocation/strangulation (20.2%), and sharp force lung trauma (7.3%). The type of offenders, injury methods, types of injuries, distribution of injuries, mechanism of death, and causes of death were significantly different among victims of different age groups. Eighteen (9.33%) victims displayed no external evidence of trauma.
  
  
  CONCLUSIONS
  The patterns of injuries, mechanism of death, and causes of death were different among victims of different age groups. A female predominance was noted among the victims aged 0-5. Complete forensic autopsy is necessary to identify child homicide. This report will help forensic examiners and forensic pathologists recognize the signs of child homicide and serve as a working basis for these professionals.
authors.affiliation: Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen Ai Rd., Taipei, Taiwan 100, ROC; National Taiwan University, Children and Family Research Center, Leader of Division, No. 1, Sec. 4, Roosevelt Rd., Taipei, Taiwan 106, ROC.
authors.forename: Hsiao-Lin
authors.initials: HL
authors.lastname: Hwa
authors.affiliation: Institute of Forensic Medicine, Ministry of Justice, No. 123, Min'an St., Zhonghe Dist., New Taipei City, Taiwan 235, ROC.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Pan
authors.affiliation: Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen Ai Rd., Taipei, Taiwan 100, ROC.
authors.forename: Guang-Ming
authors.initials: GM
authors.lastname: Shu
authors.affiliation: Department of Medical Research, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, Taiwan 100, ROC.
authors.forename: Chin-Hao
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Institute of Forensic Medicine, Ministry of Justice, No. 123, Min'an St., Zhonghe Dist., New Taipei City, Taiwan 235, ROC.
authors.forename: Tsui-Ting
authors.initials: TT
authors.lastname: Lee
authors.affiliation: Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, No. 1, Sec. 1, Jen Ai Rd., Taipei, Taiwan 100, ROC. Electronic address: jimlee@ntu.edu.tw.
authors.forename: James Chun-I
authors.initials: JC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002649:Child Abuse / Q000401:mortality; D002675:Child, Preschool; D019548:Crime Victims / Q000706:statistics & numerical data; D005260:Female; D049429:Forensic Pathology; D006708:Homicide / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality / Q000473:pathology*
keywords: Cause of death; Child abuse; Child homicide; Filicide–suicide; Forensic autopsy