Comparative study on the underlying cause and mode of death established prior to and after medicolegal autopsy.

A comparative study was made on the underlying cause and mode of death determined in 600 consecutive cases by forensic physicians before and after medicolegal autopsy. All available information including police records, medical documents of decedents and the results of the external medicolegal examination of the corpse were utilized to determine the cause and mode of death before autopsy. The mode of death would have been defined erroneously in 10% of cases and the underlying cause of death in 29.5% of cases if medicolegal autopsy had not been performed. The present results are consistent with previous studies which indicate that the determination of the underlying cause of death is significantly more accurate when an autopsy is performed. They also suggest that in a large number of routine medicolegal cases a similar trend, but at a lower rate, is associated with the determination of the mode of death.

Deaths from ischaemic heart disease in Helsinki in the years 1959-1968. Vital statistics and medico-legally autopsied sudden deaths.

According to the official vital statistics, altogether 10910 deaths from ischaemic heart disease (IHD) occurred in persons resident in Helsinki during the 10-year period 1959-68. A significant increase was found in the incidence of IHD deaths in both sexes even though changes in the structure of the population were taken into account. The increase in the age-dependent incidence of IHD deaths was most conspicuous at middle age in both sexes and in young males. Altogether 3044 IHD deaths occurring unwitnessed or within 24 hours of the onset of the fatal attack were autopsied medico-legally during the 10-year period of the study. The medico-legally autopsied cases obviously represented a high proportion of sudden IHD deaths occurring outside hospitals in Helsinki. A clear male preponderance was found in the autopsy material as compared with all IHD deaths. The prevalence of cases of acute myocardial infarction varied in different years from 27 to 49 percent at medico-legal autopsies. No significant change occurred during the 10-year period in the distribution of the medico-legally autopsied IHD deaths into social groups, in the suddenness or place of death. The home was the most common place of death. From 1963 onwards the patients dying from an ischaemic heart attack during transportation to hospital or in an outpatient department constituted 6-7 percent of all annual IHD deaths.