TY  - JOUR
PY  - 2019//
TI  - Elevation of postmortem cerebrospinal fluid sodium and chloride levels is a potential adjunct test in the diagnosis of salt water drowning
JO  - American journal of forensic medicine and pathology
A1  - Garland, Jack
A1  - McCarthy, Sinead
A1  - Hensby-Bennett, Sarah
A1  - Philcox, Winston
A1  - OʼRegan, Toni
A1  - Rousseau, Guillaume
A1  - Palmiere, Cristian
A1  - Elstub, Hannah
A1  - Cala, Allan
A1  - Clifton, Leah
A1  - Lam, Leo
A1  - Barker, Claire
A1  - Ondruschka, Benjamin
A1  - Woydt, Lina
A1  - Spark, Amy
A1  - Kesha, Kilak
A1  - Morrow, Paul
A1  - Glenn, Charley
A1  - Stables, Simon
A1  - Tse, Rexson
SP  - 251
EP  - 257
VL  - 40
IS  - 3
N2  - Postmortem vitreous humor biochemistry is a useful test in the diagnosis of salt water drowning (SWD). A significant limitation of vitreous humor is the potential effect of prolonged immersion. A recent animal study and case report suggested that cerebrospinal fluid biochemistry may be an alternative to vitreous because it is more resistant to the effects of immersion, given its protected anatomical location. This study compared postmortem cerebrospinal fluid sodium and chloride (PMCSC) levels collected via ventricular aspiration (PMCSC_V) and via lumbar puncture (PMCSC_L) in 13 SWD and 31 nonimmersion deaths. It showed a significant elevation in PMCSC levels in SWD deaths for both PMCSC_V and PMCSC_L (P < 0.05). The areas under the curve on the receiver operating characteristic curves for PMCSC_V and PMCSC_L were 0.73 and 0.83, respectively. The optimal cutoff for PMCSC_V was 216 mmol/L (sensitivity, 0.60; specificity, 0.72; likelihood ratio, 1.80; positive predictive value, 0.45) and for PMCSC_L was 241 mmol/L (sensitivity, 0.78; specificity, 0.73; likelihood ratio, 2.89; positive predictive value, 0.46). This study supports PMCSC levels as another biochemical test that can potentially aid in the diagnosis of SWD, particularly in cases where vitreous humor samples are unavailable or uninterpretable.<p />  <p>Language: en</p>
LA  - en
SN  - 0195-7910
UR  - http://dx.doi.org/10.1097/PAF.0000000000000488
ID  - ref1
ER  -