Citation

Pham T, Young C, Woodford N, Ranson D, Young CMF, Ibrahim JE. BMJ Open 2019; 9(5): e026118.

Affiliation

Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia.

Copyright

(Copyright © 2019, BMJ Publishing Group)

DOI

10.1136/bmjopen-2018-026118

PMID

31110093

Abstract

OBJECTIVES: To describe the characteristics of deaths reported to the Coroners Court of Victoria (CCOV) during Victoria's last heatwave (14-17 January 2014) and subsequent 4 days (18-21 January) using medicolegal data obtained from both the police investigation report and the pathologist's report. DESIGN, SETTING AND PARTICIPANTS: A single-jurisdiction population-based retrospective analysis of consecutive heat-related deaths (HRDs) reported to the CCOV between 14 and 21 January 2014 with a historical comparison group. MAIN OUTCOME MEASURES: Descriptive statistics were used to summarise case demographics, causes of death and the types of investigations performed. The cases from 2014 were subgrouped into HRD and non-HRD.

RESULTS: Of the 222 cases during the study period in 2014, 94 (42.3%) were HRDs and 128 (57.7%) were non-HRDs. HRDs were significantly older than non-HRDs (70.5 years: SD=13.8 vs 61.0 years: SD=22.4, t(220)=3.60, p<0.001, 95% CI 4.3 to 14.6). The most common primary cause of death in HRDs was circulatory system disease (n=57, 60.6%), which was significantly higher when compared with non-HRDs (n=39, 30.5%; χ²=20.1, p<0.001, OR 3.5, 95% CI 2.0 to 6.2). HRDs required significantly greater toxicology investigation (89.4% (n=84) vs 71.9% (n=92); χ²=10.9, p<0.001, OR 3.3, 95% CI 1.54 to 7.03) and greater vitreous biochemistry testing (40.4% (n=38) vs 16.4% (n=21); χ²=16.0, p<0.001, OR 3.5, 95% CI 1.9 to 6.5).

CONCLUSIONS: A heatwave places a significant burden on death investigation services. The inclusion of additional laboratory tests and more detailed circumstantial information are essential if the factors that contribute to HRDs are to be identified.

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

coroner; heat-related death; heatwave; medico-legal