title: Causes of death among detainees: a statistical study on the casework of the Forensic Medicine Institute in Cluj-Napoca during the period 2000-2014.
abstract: OBJECTIVE
  The detainees' right to healthcare is granted by laws, in accordance with EU directives and recommendations to which our country has consented. Prison population is a particularly vulnerable and marginalized group characterized by mortality rates different from the general population. This study aims at providing a picture of the causes of death, quality of healthcare and measures needed to reduce the number of in-prison deaths, including legal medicine expertise in view of sentence postponement/interruption.
  
  
  METHODS
  The present paper is based on the statistical analysis of in-prison deaths casework recorded at the Forensic Medicine Institute of Cluj-Napoca and provided by territorially subordinated counties forensic services. The data collected cover over 15 years (2000-2014), a period long enough for significant retrospective statistical analysis.
  
  
  RESULTS
  The total number of deaths among the inmates was 113, the majority of male sex (110). Distribution by age groups shows a greater incidence among inmates aged 50 to 59 years (32 cases, 28.31%), followed by those in their 40s' (30 cases, 26.54%) and 30s' (25 cases, 22.12%). The most frequent pathological causes of death were cardiovascular (53 cases) followed by tumors (26 cases) and infectious diseases. A significant number of deaths were due to violent causes (14 cases-12,38%).
  
  
  CONCLUSIONS
  Special problems are raised by the high number of deaths among prisoners, especially at a young age, while the high frequency of violent deaths from self- or non-self-inflicted traumatic causes requires supervision, monitoring and continuous analysis. Despite recent improvements, healthcare in prisons still poses some problems, mainly regarding diagnosis and treatment of heart diseases, neurosurgery and cancer.
authors.affiliation: Department of Community Medicine, Forensic Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Gherman
authors.affiliation: Department of Community Medicine, Forensic Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Ovidiu
authors.initials: O
authors.lastname: Chiroban
keywords: health care; inmates; mortality rate; prison