PubMed Health⌕ Search

Biomedical subjects

S Asnaes

Publications and source records attributed to S Asnaes.

41 records · Page 3Linked to original sources
PubMedDate not supplied

Uncertainty of determining mode and cause of death without autopsy: an autopsy study of medically unattended non-medicolegal deaths.

Eighty-seven cases of medically unattended deaths were autopsied and investigated for alcohol and barbiturate after the general practitioner had certified the death. A detailed survey was made by comparing the mode and cause of death before and after autopsy. After autopsy and chemical analysis, two suicides, one accidental death and two unknown modes of death were found (5%). The high proportion of unknown mode of death was due to the fact that police investigations were not made. The cause of death differed in 30%. It was mostly due to overestimation of ischaemic heart disease, especially acute myocardial infarction, cerebral haemorrhage and because the unknown cause of death could be placed in a definite group after autopsy. Estimated acute myocardial infarciton could only be confirmed in 50% of the cases. Neoplastic disorders as the cause of death was seldom found to be erroneous, but malignancy was undiagnosed in 4% of all cases. It is concluded that doctors should not use acute myocardial infarction as a cause of death unless there is reasonable clinical evidence for the diagnosis, that obscure cases of death should be left to medicolegal investigation, and that the reliability of mortality statistics still has to be improved. The autopsy is still valuable to ensure this extra security.

Adult↗
PubMedDate not supplied

Uncertainty of determining mode of death in medicolegal material without autopsy--a systematic autopsy study.

Systematic autopsy was performed in 807 medicolegal deaths where the police had not requested autopsy. In all cases both the cause of death and the mode of death had been reported at the medicolegal external examination. The autopsy revealed differences in the mode of death in about 4% of all cases. This was due in particular to the problems associated with distinguishing presumed natural deaths from accidents and suicide. The cases of "concealed" suicide were found in particular among the higher age groups. However, no characteristic relationship was found between the proportion of differing modes of death and the age groups. All cases of homicide were recognized at the medicolegal external examination. Malignant disease that had not been diagnosed previously was found in about 4% of the cases, the reason being the large proportion of elderly subjects in the material. Syphilitic aortitis that had not been previously diagnosed was demonstrated in about 1% of all cases, and pulmonary tuberculosis that had not been previously diagnosed was demonstrated in 0.7% of the cases. The conclusion is that the results provide no support for replacing the medicolegal autopsy by medicolegal external examination alone, but rather suggest that the proportion of medicolegal autopsies should be increased.

Accidents↗
PubMedDate not supplied

The value of the hospital autopsy. A study of causes and modes of death estimated before and after autopsy.

Among 312 consecutive deaths in a Danish Central Hospital autopsy was performed in the pathology department on 266 cases, i.e. 85%. Retrospectively, the underlying causes of death were estimated from the clinical information alone by an experienced clinician and subsequently compared with the autopsy report. The definite cause of death was determined jointly by the clinician and the pathologist. The clinician's diagnosis was thereby confirmed as incorrect in 18% of the cases if small differences in site and type of malignant tumours were not considered. This is less than in many other investigations, but it is stressed that this could partly be because formal errors in completing the death certificate were avoided. The main causes of death were ischaemic heart disease and neoplasia. Clinical diagnosis of malignant diseases was never found to be erroneous. There was a slight tendency to clinically overestimate ischaemic heart disease, but in general the different errors outweighed each other, so that the total number of different causes of death before and after autopsy was nearly the same. The original death certificate was investigated in 12 accidental cases. Hereby it was found that the mode of death was originally stated erroneously as natural in 7 cases, i.e. 4.5%. It is concluded that hospital autopsy is still needed for the control and correction of causes of death, and it is stressed that clinicians as well as pathologists should be more aware of cases with a trauma in the history to avoid errors in the mode of death. Such errors can imply legal as well as insurance problems.

Accidents, Home↗
PubMedDate not supplied

The importance of medico-legal autopsies. An analysis of the complex problems regarding damages.

One hundred forty-four medico-legal autopsies were performed at the University Institute of Forensic Medicine in Copenhagen during the period 1973-77, all requested by the National Office of Social Security in order to estimate whether the cause of death could be related to the work of the deceased. The total number of medico-legal autopsies in the same period was 4050. The material included only four women. One hundred seventeen men died during work, 26 cases were accepted. Clear cases of accidents were always accepted and damages were paid. In cases where the deceased died on his way to or from work damages were rejected. Nineteen men (13%) had died after returning to their homes. Two cases among these were accepted (fall from scaffolding during working hours, arsenic poisoning where death occurred later in hospital). The mean age of the group was about 50 years, which is less than in an average medico-legal population. In all cases but two the autopsy revealed the cause of death, i.e. that unknown causes of death totalled 1.4%. The manner of death was elucidated in all cases. The most frequent cause of death in men turned out to be coronary sclerosis and coronary thrombosis. All such cases were rejected as being due to working conditions, because in no case was extraordinary working stress found to be evident. The two cases of death which occurred at home showed the importance of being aware of injuries due to working conditions, even if death could not be directly related to an industrial accident.

Accidents, Occupational↗