Post-mortem imaging compared with autopsy in trauma victims – A systematic review

Jalalzadeh, Hamid; Giannakópoulos, Georgios F.; Berger, Ferco H.; Fronczek, Judith; Goot, F. R. W. Van De; Reijnders, Udo; Zuidema, Wietse P.

doi:10.1016/j.forsciint.2015.07.026

Cited by 84 publications

(49 citation statements)

References 41 publications

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“…This review will be increasingly post--publication. This is considerably aided if systematic reviews are possible for specific circumstances of death, such as a recent review of traumatic death [21].…”

Section: Discussionmentioning

confidence: 99%

“…This means that regardless of our view of peer--review, the reader should mistrust it and rely on our own "post--publication" peer--review, not just from 'letters to the editor' but on a comprehensive discussion of the "market of ideas" [20]. Ideally this would be supported by high quality systematic reviews, but these are only possible when there is enough data on a single circumstance of death with similar questions to study, for example traumatic death [21].…”

Section: Bias In Research Methods and Findingsmentioning

confidence: 99%

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How does post-mortem imaging compare to autopsy, is this a relevant question?

Morgan

Rutty

2016

Journal of Forensic Radiology and Imaging

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HighlightsEvidence of "efficacy" for a test does not imply it is effective in the real world Direct comparisons between autopsy and imaging may give misleading results Imaging is used in a wide variety of contexts, all with different questions The level of accuracy required of an imaging test depends on the context Research findings in one context may not be applicable in all contexts AbstractThe rapid development of imaging techniques used for the investigation of death invites the question "how does imaging compare with autopsy". This article is based on an invited talk given to the International Society of Forensic Radiology and Imaging in 2015 and attempts to show that this question cannot be answered, as it is in fact several questions depending on the circumstances of death. Review of the literature is fraught with difficulties due to the rapid evolution of technology, the varied circumstances of death investigation and the multiple possible post--mortem investigations that imaging can be compared with. The article focuses on the assessment of adult sudden natural death and suggests the questions that need to be answered.

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Section: Discussionmentioning

confidence: 99%

Section: Bias In Research Methods and Findingsmentioning

confidence: 99%

How does post-mortem imaging compare to autopsy, is this a relevant question?

Morgan

Rutty

2016

Journal of Forensic Radiology and Imaging

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“…A 2007 study examining the correlation between the autopsy and CT as it related to sensitivity, speci icity, and positive predictive values reported sensitivity ranging from 0-75% and overall an inadequate forensic tool for the detection of traumatic injuries (32). Additional studies on post-mortem imaging reported that the cause of death is frequently missed using CT and MRI as a method of cause of the diagnosis or in trauma cases [33,34]. At this point post-mortem imaging is not a subs tuition for the physical autopsy [35].…”

Section: The Rationale For Not Conducting the Autopsy Was Insuffi Cientmentioning

confidence: 99%

Failure to Autopsy: The Otto Warmbier Case

Koehler¹

2017

J Forensic Sci Res

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Coroner and medical examiner offi ces are charged with the medicolegal investigation of deaths to determine the cause and manner of death. We describe the recent high-profi le case of Otto Warmbier, who tragically died shortly after his return in a coma from North Korea and in which the coroner failed to conduct a complete autopsy, and failed to satisfy the needs of the local, national, and international communities.Medico legal death investigation offi ces, including both medical examiner and coroner offi ces, have a legal responsibility and duty to investigate deaths in the public interest for public safety and public health purposes. Although, they serve the families of the deceased as they can, their raison d'être and priority is service to the greater public good. Thus, they may conduct investigations and even autopsies over the objections of the nextof-kin. Full investigations include a complete forensic autopsy. The utilitarian public interest should, within the constraints of the offi ce resources, drive the decision of whether to autopsy or not. Failure to autopsy can sometimes constitute a breach of faith that the public entrusts in these offi ces. Empirically, this seems to be a greater problem in coroner jurisdictions than in medical examiner offi ces. Specifi cally, we believe the recent case of Otto Warmbier is such a case.

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“…Ever since the 1970s, when computed tomography (CT) was first introduced into the medical field, its importance in clinical diagnostics and post-mortem examinations has been steadily growing [1]. Post-mortem computed tomography (PMCT) is useful in the diagnosis of pneumothorax, and in ascertaining the cause of death [2].…”

Section: Introductionmentioning

confidence: 99%

Analysis of cases of traumatic pneumothorax – conclusions based on post-mortem CT examinations for routine autopsy diagnostics

Lopatin¹,

Moskała²,

Woźniak³

et al. 2019

amsik

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StreszczenieAnalizie poddano 450 przypadków z lat 2017-2018, w których doszło do zgonu w wyniku wypadku drogowego, upadku z wysokości i przygniecenia. Badania pośmiertne wykonane w Zakładzie Medycyny Sądowej w Krakowie obejmowały równolegle konwencjonalną sekcję zwłok i pośmiertną tomografię komputerową (PMCT). Celem pracy była ocena częstości występowania odmy opłucnowej w badanej grupie oraz próba korelacji odmy z obecnością konkretnych rodzajów obrażeń w obrębie klatki piersiowej i okolicznościami doznania urazu. Wykorzystanie danych z PMCT w analizowanej grupie pozwoliło ujawnić odmę opłucnową w 43% przypadków. Istotną obserwacją było występowanie odmy prężnej z zapadnięciem płuca i przesunięciem śródpiersia u 16% zwłok objętych badaniem. Wśród obrażeń towarzyszących odmie opłucnowej najczęstsze były złamania rusztowania kostnego klatki piersiowej (żeber, mostka, kręgosłupa) i zranienia płuc. W 20% przypadków odmie opłucnowej towarzyszyła rozedma podskórna, a w 11% obserwowano wyraźną asymetrię klatki piersiowej. Okoliczności urazu, w których dochodziło do powstania przestrzeni powietrznych w jamach opłucnej, to przede wszystkim upadki z wysokości oraz potrącenia.Słowa kluczowe: sekcja zwłok, pośmiertna tomografia komputerowa, PMCT, uraz, odma opłucnowa. AbstractThe analysis comprised a total of 450 cases covering the period 2017-2018, in which death was a result of traffic accident, fall from a height, and crushing. Post-mortem examinations carried out at the Department of Forensic Medicine in Krakow consisted of conventional autopsy and post-mortem computed tomography (PMCT). The aims of the study were to evaluate the prevalence of pneumothorax in the study group, and attempt to identify a correlation between pneumothorax and the presence of specific types of thoracic injuries and the circumstances of trauma. Based on the PMCT data, pneumothorax was detected in 43% of cases in the study group. An important finding was the presence of tension pneumothorax with lung collapse and mediastinal shift in 16% of cadavers in the study group. The main injuries accompanying pneumothorax were found to be fractures of the rib cage (ribs, sternum, spine) and lung injuries. In 20% of cases, pneumothorax was shown to coexist with subcutaneous emphysema. In 11% of cases, marked asymmetry of the chest was noted. The circumstances of trauma resulting in the accumulation of air in the pleural cavities included primarily falls from a height and hits by a vehicle.

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Post-mortem imaging compared with autopsy in trauma victims – A systematic review

Cited by 84 publications

References 41 publications

How does post-mortem imaging compare to autopsy, is this a relevant question?

How does post-mortem imaging compare to autopsy, is this a relevant question?

Failure to Autopsy: The Otto Warmbier Case

Analysis of cases of traumatic pneumothorax – conclusions based on post-mortem CT examinations for routine autopsy diagnostics

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