Autopsy rate in suicide is low among elderly in Denmark compared with Finland

Ylijoki-Sørensen, Seija; Boldsen, Jesper L.; Boel, Lene Warner Thorup; Bøggild, Henrik; Lalu, Kaisa; Sajantila, Antti

doi:10.1016/j.forsciint.2014.08.035

Cited by 14 publications

(11 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These studies documented systematically lower autopsy rates in Denmark than in Finland, particularly for suicides [161], and linked this to a much higher frequency of ill-defined and unknown cause of death codes in the Danish death statistics compared to the Finnish [162]. However, in a costconsequence analysis of the cause of death investigations in the two countries, the same group of researchers stated that the implementation of an alternative practice increasing the autopsy rates in Denmark comes at a price, with costs per 10,000 deaths estimated to increase by about 50% compared to current practice [163].…”

Section: Paper I -Autopsy Rates and General Toxicological Findingsmentioning

confidence: 98%

“…Thus, the potential benefit of sustaining adequate autopsy practices for public health and preventive medicine does not seem to be less relevant in rural areas. Since the publication of paper I, some interesting studies investigating various aspects of the differences in autopsy rates between Denmark and Finland have also been published [161][162][163].…”

Section: Paper I -Autopsy Rates and General Toxicological Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

Frost

Løkken

Helland

et al. 2016

Forensic Science International

View full text Add to dashboard Cite

This article presents levels and tissue distribution of codeine, codeine-6-glucuronide (C6G), norcodeine, morphine and the morphine metabolites morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G) in post-mortem blood (peripheral and heart blood), vitreous fluid, muscle, fat and brain tissue in a series of 23 codeine-related fatalities. CYP2D6 genotype is also determined and taken into account. Quantification of codeine, C6G, norcodeine, morphine, M3G and M6G was performed with a validated solid phase extraction LC-MS method. The series comprise 19 deaths (83%) attributed to mixed drug intoxication, 4 deaths (17%) attributed to other causes of death, and no cases of unambiguous monointoxication with codeine. The typical peripheral blood concentration pattern in individual cases was C6G≫codeine≫norcodeine>morphine, and M3G>M6G>morphine. In matrices other than blood, the concentration pattern was similar, although in a less systematic fashion. Measured concentrations were generally lower in matrices other than blood, especially in brain and fat, and in particular for the glucuronides (C6G, M3G and M6G) and, to some extent, morphine. In brain tissue, the presumed active moieties morphine and M6G were both below the LLOQ (0.0080mg/L and 0.058mg/L, respectively) in a majority of cases. In general, there was a large variability in both measured concentrations and calculated blood/tissue concentration ratios. There was also a large variability in calculated ratios of morphine to codeine, C6G to codeine and norcodeine to codeine in all matrices, and CYP2D6 genotype was not a reliable predictor of these ratios. The different blood/tissue concentration ratios showed no systematic relationship with the post-mortem interval. No coherent degradation or formation patterns for codeine, morphine, M3G and M6G were observed upon reanalysis in peripheral blood after storage.

show abstract

Section: Paper I -Autopsy Rates and General Toxicological Findingsmentioning

confidence: 98%

Section: Paper I -Autopsy Rates and General Toxicological Findingsmentioning

confidence: 99%

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

Frost

Løkken

Helland

et al. 2016

Forensic Science International

View full text Add to dashboard Cite

show abstract

“…Our finding of lower mortality from alcohol-related causes in the displaced population suggests that these people had personal or social resources that could protect from suicidal behaviour. Classification of causes of death in Finland is considered to be of very high quality due to the high autopsy rate 25 , and therefore misclassification bias with respect to suicide is unlikely to explain this specific finding.…”

Section: Why Forced Migration Can Be Protective For Suicide?mentioning

confidence: 99%

The Impact of Forced Migration on Mortality

Haukka

Suvisaari

Sarvimäki³

et al. 2017

Epidemiology

View full text Add to dashboard Cite

show abstract

“…38 This happens in violation of the Recommendation No. R 99 of the Committee of Ministers (Council of Europe) adopted since 1999 41,42 but only partially applied in several European Countries.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately in Italy majority of traumatic and violent deaths are certified without autopsy and this seems to occur also in those countries where external examination of the body is the most common method used to investigate medico-legal deaths or where investigation can proceed with a forensic autopsy only if a crime is suspected or the manner of death is unclear. 18,21,38 In Italy a significant amount of medico-legal investigations (especially for deaths resulted from trauma following suicide or accidental events like motor vehicle crashes, domestic or occupational accidents) are restricted to an external body examination without subsequent autopsy and/or a crime scene survey even if the event is uncertain. We are talking about 4e5% of all deaths (approximately 580.00 per year) which means with an optimistic estimation there are at least some thousand of forensic autopsies per year that should be performed in every traumatic and violent case.…”

Section: Discussionmentioning

confidence: 99%

Undetected patricide: Inaccuracy of cause of death determination without an autopsy

Campobasso

Laviola

Grattagliano

et al. 2015

Journal of Forensic and Legal Medicine

View full text Add to dashboard Cite

Patricide (killing the father) is uncommon form of homicide. Usually the assaults occur at home in the absence of witnesses and adult sons are frequently involved. Homicides in a domestic context usually do not tend to recurrence, because the motivation for the crime ends with the death of the parent. However, this is not what was observed in the present case study dealing with the death of a 70 years old white man originally misclassified as accident and discovered three years later only after an additional homicide in a family context of a 60 years old white lady. Multiple stab wounds to the neck and thorax were misinterpreted at the external male body examination as blunt trauma falling down stairs. No forensic autopsy was requested and no comparison of medical findings with the results from the death scene, such as a bloodstain analysis was performed by the police officers nor required by the judicial authority. This was quite surprising because an additional but preliminary post-mortem external examination performed by a general practitioner on the male body already raised the suspicion that the external lesions were stab wounds thus requiring a forensic autopsy. Only the exhumation of the elderly body, performed years later, confirmed the diagnostic hypothesis raised by the first physician. The present case is quite representative of a death investigation not run professionally and performed by individuals with no specific training where most of the medico-legal investigations (especially for traumatic and violent deaths) are restricted to an external body examination without subsequent autopsy. Although misinterpretation of external lesions is inevitable and significant discrepancies between external body examination and forensic autopsy are not rare, in the case of contradictory results of post-mortem external examination or unclear/suspicious cause and manner of death, investigation should proceed necessarily with a forensic autopsy.

show abstract

Autopsy rate in suicide is low among elderly in Denmark compared with Finland

Cited by 14 publications

References 28 publications

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

Post-mortem levels and tissue distribution of codeine, codeine-6-glucuronide, norcodeine, morphine and morphine glucuronides in a series of codeine-related deaths

The Impact of Forced Migration on Mortality

Undetected patricide: Inaccuracy of cause of death determination without an autopsy

Contact Info

Product

Resources

About