title: Characteristics, circumstances and pathology of sudden or unnatural deaths of cases with evidence of pathological hoarding.
abstract: The study aimed to determine the characteristics and circumstances of cases sudden or unnatural death (n = 61) with evidence of pathological hoarding, their major organ pathology and toxicology. The mean age was 65·8 yrs (a mean of 16.1 years of potential life lost), 62·3% were male, and 28·2% were obese. 95·1% lived alone, and 96·7% died in their residence, with no medical intervention. In all cases severe squalor and extensive hoarding were noted. The direct cause of death was attributed to disease in 75·4%, heart disease being a significant factor in 52·5%. Accidents causing death directly related to hoarding occurred in two cases. Autopsy revealed extensive pathology: severe coronary artery narrowing (42·4%), myocardial replacement fibrosis (44·1%), emphysema (39·0%), nephrosclerosis (46·6%). Signs of hypothermia were present in 14·8%, and diabetes was diagnosed in 21·3%. The most commonly detected substance was alcohol (32·1%). Medications for heart disease (5·4%) or diabetes (7·1%) were rare. The overall clinical picture was of an isolated group, with a heavy burden of physical disease and, in all probability, a high level of psychiatric disorders, who died alone in their homes.
authors.affiliation: National Drug & Alcohol Research Centre, University of New South Wales, Australia. Electronic address: s.darke@unsw.edu.au.
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
authors.affiliation: National Drug & Alcohol Research Centre, University of New South Wales, Australia; Sydney Medical School, University of Sydney, NSW, Australia.
authors.forename: Johan
authors.initials: J
authors.lastname: Duflou
mesh_terms: D000061:Accidents, Home / Q000401:mortality; D000368:Aged; D001315:Australia / Q000453:epidemiology; D000067401:Blood Alcohol Content; D002423:Cause of Death; D003645:Death, Sudden / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000473:pathology; D004646:Emphysema / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D005555:Forensic Psychiatry; D006331:Heart Diseases / Q000401:mortality / Q000473:pathology; D000067836:Hoarding Disorder / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D007035:Hypothermia / Q000473:pathology; D007674:Kidney Diseases / Q000473:pathology; D008297:Male; D009765:Obesity / Q000453:epidemiology; D012934:Social Isolation
chemical_list: D000067401:Blood Alcohol Content
keywords: Circumstances; Demographics; Hoarding; Pathology; Toxicology