질식사의 새로운 분류에 따른 2012년도 법의부검의 질식사 분류

Abstract

No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 thatdivided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classifyasphyxia into four main categories: suffocation, strangulation, mechanical asphyxia,and complicated asphyxia. Suffocation includes smothering and choking as well asconfined spaces, entrapment, and vitiated atmosphere. Strangulation is subdividedinto hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally,complicated asphyxia is defined as cases with two or more identifiable mechanisms ofasphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxiaand classify them according to our proposed asphyxia classification system. In 24.7%of cases, the age range was 40-49 years, and 51.9% were men. The most commonmethod of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manualstrangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature,and manual strangulation were usually homicides. Eighteen cases were complicatedasphyxia. This classification provides a simplified, unified, and useful tool to classifyand understand deaths due to asphyxia.