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KERD
논문KCI 등재

응급실에서 사망선고된 변사자의 사인에 대한 법의학적 분석

Forensic Analysis of the Cause of Death and Death on Arrival of Patients at the Emergency Room

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주제분류기타의약학

초록

From January 2007 to June 2012, 55 autopsy cases were reviewed, in which death occurred outside the hospital and the patients were declared dead on arrival at the emergency departments, in order to compare the clinical and postmortem examination diagnoses of death-on-arrival patients in tertiary hospitals in Busan, Yangsan and Ulsan city. Of 22 non-traumatic deaths, 21 occurred from natural causes and 1 from unknown cause (sudden infant death syndrome, SIDS). Clinical diagnoses were cardiovascular diseases or “non-traumatic” / “unknown” while autopsy diagnoses were majorly cardiovascular diseases, especially coronary artery diseases (72.7%). Of 33unnatural deaths, the cause of death was blunt trauma in 4 patients, sharp-force injury in 6, falling in 10, gunshot injury in 1, traffic accidents in 3, asphyxia in 2, drowning in 2, fire-related death in 1, and intoxication in 4. There were no definite discrepancies between clinical and autopsy diagnoses, except for 5 non-traumatic deaths and 2unnatural deaths. These results suggest that the role of the emergency department may be crucial in postmortem investigations.

Abstract

From January 2007 to June 2012, 55 autopsy cases were reviewed, in which death occurred outside the hospital and the patients were declared dead on arrival at the emergency departments, in order to compare the clinical and postmortem examination diagnoses of death-on-arrival patients in tertiary hospitals in Busan, Yangsan and Ulsan city. Of 22 non-traumatic deaths, 21 occurred from natural causes and 1 from unknown cause (sudden infant death syndrome, SIDS). Clinical diagnoses were cardiovascular diseases or “non-traumatic” / “unknown” while autopsy diagnoses were majorly cardiovascular diseases, especially coronary artery diseases (72.7%). Of 33unnatural deaths, the cause of death was blunt trauma in 4 patients, sharp-force injury in 6, falling in 10, gunshot injury in 1, traffic accidents in 3, asphyxia in 2, drowning in 2, fire-related death in 1, and intoxication in 4. There were no definite discrepancies between clinical and autopsy diagnoses, except for 5 non-traumatic deaths and 2unnatural deaths. These results suggest that the role of the emergency department may be crucial in postmortem investigations.

참고문헌 (6)

  1. Tavora F, "Discrepancies in initial death certificate diagnoses in sudden unexpected outof- hospital deaths: the role of cardiovascular autopsy", Cardiovasc Pathol, 17, pp.178~182 (2008)
  2. Kang YS, "Survey of the causes of death on the death certificates of DOA patients", J Korean Soc Emerg Med, 12, pp.385~392 (2001)
  3. Lee JH, "Autopsy results of out-ofhospital cardica arrest", Korean J Leg Med, 33, pp.111~115 (2009)
  4. Buschmann CT, "Clinical diagnosis versus autopsy findings in polytrauma fatalities", Scand J Trauma Resusc Emerg Med, 18, pp.55~ (2010)
  5. Na JY, "The discrepancy of the causes of death between medical death certificates and autopsy reports", Korean J Leg Med, 33, pp.10~18 (2009)
  6. 옥택근, "시체검안서 작성을 위한 사망 원인 조사 방법에 관한 연구", 대한응급의학회지, 17(3), pp.245~253 (2006), 대한응급의학회

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