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Citation |
資樹, 征樹, 文子, 良久, 由布. J. Jpn. Counc. Traffic Sci. 2016; 15(2): 20-27. |
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Vernacular Title |
交通外傷における合併症に伴う遅延性死亡：法医剖検例からの検討 |
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Copyright |
(Copyright © 2016, The Japanese Council of Traffic Science) |
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DOI |
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PMID |
unavailable |
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Abstract |
The distribution of survival time after a traffic accident-related injury shows a declining curve followed by the first peak of acute death within 1 h. Annually, the police department officially announces the number traffic deaths occurring within 30 days after accidents, in addition to those occurring within 24 h. For deaths delayed by more than 24 h, the proximate causal relation of an accident to the victim's death is often a social matter handled by courts and insurance companies. A review of forensic autopsy files from our department during 1999-2013 revealed 22 cases of delayed traffic deaths from complications including infectious disorders（n=10）, pulmonary embolism（n=9）, and others. Bacterial infection cases, diagnosed at postmortem examinations as pneumonia and sepsis, showed a mean survival time of 105.9 days, and mean age of 63.4-years old. Elderly people tend to suffer infectious disorders, and central nervous system injury accounted for eight cases. Pulmonary embolisms included fat embolism syndrome（n=5） and acute pulmonary thromboembolism（n=4）. Fat embolism syndrome and pulmonary thromboembolism respectively exhibited mean survival times of 3.7 days and 12.0 days, with respective mean injury severity score values of 20.4 and 11.8, indicating that the pulmonary embolism patients did not suffer from critical injuries in traffic accidents. Pedestrians （n=11） and motorcyclists（n=7）accounted for most road users. Regarding the delayed deaths from infectious disorders, forensic autopsy should be performed only for a few patients because of sufficient diagnosis at the hospital. In contrast, many patients who had not been expected to die collapsed from pulmonary embolism several days after injury. Their cause of death had not been diagnosed until autopsy. Extensive forensic investigations need to be performed for delayed traffic deaths. Language: ja |