title: Evaluation of Acute Alcohol Intoxication as the Primary Cause of Death: A Diagnostic Challenge for Forensic Pathologists.
abstract: Deaths caused by acute alcohol intoxication (AAI) remain a major public health issue. This study is retrospective and descriptive: an 8-year case analysis of deaths due to AAI in Maryland. Study showed that of 150 AAI deaths, the death rate among Hispanics (10.41/100,000 population) was significantly higher than all the non-Hispanics combined (1.88/100,000 population). The majority of individuals were young adults, overweight, and binge drinkers. The obese group showed significantly lower mean heart and peripheral blood alcohol concentration (BAC) (0.36%, 0.37%) than the normal weight group (0.45%, 0.42%). Based on the PBAC and urine AC ratio, 49.6% deaths likely occurred close to peak phase, followed by postabsorptive phase (31.6%) and absorptive phase (18.8%). Our results indicate that forensic pathologists should evaluate postmortem BAC in the light of individual's age, drinking history, body weight, possible phase of alcohol intoxication, and other autopsy findings when certifying AAI as primary cause of death.
authors.affiliation: Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
authors.forename: Li
authors.initials: L
authors.lastname: Hu
authors.affiliation: Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
authors.forename: Lingli
authors.initials: L
authors.lastname: Hu
authors.affiliation: Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.|Office of the Chief Medical Examiner, State of Maryland, 900 West Baltimore Street, Baltimore, MD, 21223, U.S.A.|Sino-US Forensic Science Research Center, Collaborative Innovation Center of Judicial Civilization, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Office of the Chief Medical Examiner, State of Maryland, 900 West Baltimore Street, Baltimore, MD, 21223, U.S.A.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Phipps
authors.affiliation: Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.|Office of the Chief Medical Examiner, State of Maryland, 900 West Baltimore Street, Baltimore, MD, 21223, U.S.A.|Sino-US Forensic Science Research Center, Collaborative Innovation Center of Judicial Civilization, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: David R
authors.initials: DR
authors.lastname: Fowler
authors.affiliation: Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Forensic Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210029, China.|Office of the Chief Medical Examiner, State of Maryland, 900 West Baltimore Street, Baltimore, MD, 21223, U.S.A.|Sino-US Forensic Science Research Center, Collaborative Innovation Center of Judicial Civilization, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000435:Alcoholic Intoxication / Q000401:mortality*; D063425:Binge Drinking / Q000401:mortality; D000067401:Blood Alcohol Content; D015992:Body Mass Index; D002492:Central Nervous System Depressants / Q000032:analysis; D003334:Coroners and Medical Examiners; D000431:Ethanol / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017678:Sex Distribution; D014822:Vitreous Body / Q000737:chemistry; D055815:Young Adult
chemical_list: D000067401:Blood Alcohol Content; D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: acute alcohol intoxication; forensic autopsy; forensic science; forensic toxicology; obesity; postmortem alcohol concentration