Practical utility of signs of asphyxia in evaluating specific causes of death

D. D. Tăbîrcă

Abstract: The purpose of this article is to identify the particularities of signs of asphyxia in various causes of death, and to evaluate if a postmortem signs of asphyxia has any practical utility in direct and underlying causes of death. To this purpose, we performed a case control study, at the Constanța Service of Legal Medicine, with four study groups, each consisting of 50 cases - mechanical asphyxia, sudden deaths, violent death cases admitted into the hospital, violent death cases not admitted into the hospital (found dead at the Crime Scene). Results and discussions. The signs of asphyxia found during the autopsy had varying degrees of severity, depending on the cause of the initial death, being maximal in mechanical asphyxia, for which it is extremely sensitive, though not very specific. Among the signs of mechanical asphyxia, we found that the most specific for signs of asphyxia is pleural petechiae. Pulmonary stasis and epicranian patches have a high sensitivity in our experience but a rather low specificity for establishing a mechanical asphyxia as a cause of death. In sudden deaths, epicranian petechiae appear at a frequency similar to that encountered in mechanical asphyxia, but significantly less frequently than in the case of immediate or late posttraumatic deaths. As for violent death cases admitted into the hospital due to trauma, signs of asphyxia occurs less frequently than in sudden deaths or in violent deaths by mechanical asphyxia, but much more often than in case of directly fatal violent deaths. We noticed that in direct fatal deaths, signs of asphyxia are rarely established, due to the extremely short duration of survival and massive hemorrhage.
Keywords: signs of asphyxia, causes of death.