ABSTRACT
Introducción. Los boletines estadísticos correspondientes a las defunciones que requieren intervención judicial (DIJ) y actuación forense contienen un número elevado de causas de muerte mal definidas. El objetivo es presentar los resultados de la recuperación de datos a partir de las autopsias judiciales del año 2013 en Cataluña y analizar el impacto de esta información sobre la estadística de causas de muerte. Material y métodos. Se seleccionaron del Registro de Mortalidad de Cataluña las defunciones con intervención judicial que tenían como causa de muerte unas determinadas afecciones mal definidas, según criterios de codificación de la OMS. Se recuperó la información de los registros de autopsia de los centros de Patología Forense del Instituto de Medicina Legal y Ciencias Forenses de Cataluña (IMLCFC). Resultados. Las DIJ representan el 6% de la mortalidad total de Cataluña, el 42,9% de las causas externas y el 77% de las mal definidas. De los 3.639 casos de DIJ del año 2013 se revisó un 43,4% (n=1.578) y se obtuvo información que mejoró la causa de muerte del 78,4% de los revisados. La información recuperada aumentó un 61,3% las intoxicaciones accidentales, un 32,6% los suicidios, un 28,9% los homicidios, un 27,4% las caídas, un 22,7% los accidentes de tráfico y un 5,2% la cardiopatía isquémica, con el equivalente aumento de las tasas de mortalidad por estas causas. Conclusiones. La información de las autopsias judiciales tiene un gran impacto en las estadísticas de causa de muerte, especialmente en las causas externas y la cardiopatía isquémica. Un informe forense sobre la causa y las circunstancias de la muerte, de manera que permita fácilmente su codificación posterior, así como la transmisión directa de estos datos a la oficina estadística serían la mejor solución para evitar la pérdida de información que se produce actualmente (AU)
Introduction. The statistical forms corresponding to deaths that require judicial and forensic interventions contain a very high number of ill-defined causes of death. The objective is to show the results of data recovery from the forensic autopsies and to analyse the impact of this information on the cause-of-death statistics for the year 2013 in Catalonia (Spain). Material and methods. Deaths with judicial intervention with an ill-defined cause of death according to the WHO coding standards were selected from the Catalan Mortality Registry. Information was recovered from the autopsy registers of the Forensic Pathology centres of the Institute of Legal Medicine and Forensic Science of Catalonia (IMLCFC). Results. Deaths with judicial intervention represent 6% of total mortality in Catalonia, 42.9% due to external causes and 77% pertaining to ill-defined causes-of-death. There were 3,639 cases of death with judicial intervention, of which 43.4% (n=1,578) were reviewed, resulting in information that improved the cause of death in 78.4% of cases. The information retrieved increased accidental poisoning by 61.3%, suicides by 32.6%, homicides by 28.9%, falls by 27.4%, traffic accidents by 22.7% and ischaemic heart disease by 5.2%, with the equivalent increase in the mortality rates from these causes. Conclusions. The forensic autopsy information has a significant impact on cause-of-death statistics, especially external causes and ischemic heart disease. A forensic report concerning the cause and circumstances of death, structured to facilitate further coding and the direct transmission of data to the statistical office, would be the best solution to prevent the loss of information currently experienced (AU)
Subject(s)
Humans , Male , Female , Cause of Death/trends , Death , Forensic Medicine/legislation & jurisprudence , External Causes , Mortality , Legal Intervention , Poisoning/epidemiology , Autopsy/methods , Mortality Registries/standardsABSTRACT
The identification of disaster victims is the formal, organized process of identifying multiple bodies after an incident with multiple victims. The appropriate management of these incidents, particularly of the bodies, is one of the most crucial aspects of disaster response and its importance has led to the evolution of the concept of Disaster Victim Management. The aim of this study is to report how the process of identifying the 12 mortal victims of a railway accident in June 2010 in Castelldefels (Barcelona) was managed. The methodology used complied with the National Protocol for medical forensic and scientific police response to mass casualty incidents. The family assistance center also served as an ante mortem (AM) office. Despite the fragmentation of the bodies, all the victims were identified satisfactorily. The main problems observed during the management of the disaster were due to the state of the bodies, which raised many doubts as to the number of fatalities. The experience prompted a proposal to establish some recommendations on limiting the number of fragments to be analyzed genetically. We would like to stress the importance of setting up a Data Integration Center which brought together all the participating institutions, and collected and supervised all the different identification reports in a single comprehensive text addressed to the competent legal authority.
Subject(s)
Accidents , Disaster Victims , Forensic Anthropology/methods , Mass Casualty Incidents , Railroads , Adolescent , Adult , DNA Fingerprinting , Female , Humans , Male , Spain , Young AdultABSTRACT
Los principales problemas fueron la numeración en el levantamiento de cadáver-zona de registro, la coordinación médico forense-policial y en la zona del control de calidad. A pesar del buen resultado se evidenció la necesidad de formación especializada; realizar simulacros parecidos multidisciplinares y de adecuación de la normativa a las instalaciones propias. Ante un suceso con víctimas múltiples debemos adaptarnos a la legislación vigente (Real Decreto 32/2009: protocolo nacional de actuación médico-forense y de Policía Científica en sucesos con víctimas múltiples). El objetivo principal de nuestro estudio fue valorar la respuesta médico-forense mediante un simulacro con atentado bomba, con 11 individuos fallecidos siguiendo la mencionada legislación. En el levantamiento había 8 cuerpos y 22 restos. La duración programada fue de 5h. En este tiempo estaban muy avanzadas las identificaciones de 8 personas (5 mediante estudio necrodactilar, odontología y ADN y 3 mediante estudio necrodactilar y ADN)(AU)
When a disaster involving multiple victims occurs we must comply with the legal norms in force in Spain (Royal Decree 32/2009, enacting the National Protocol for the Intervention of Forensic Doctors and Scientific Police in Mass Disaster). The main aim of our study was to assess the response of Forensic Doctors through a practice simulating a bomb attack with 11 mortal victims. At the disaster scene there were 8 bodies and 22 corpse remains to be identified. The expected duration was 5 hours. In that time the identification of 8 persons was well under way (5 using fingerprint identification, odontology and DNA, and 3 using fingerprint identification and DNA). The numbering of the bodies at the specific area of the disaster scene, the coordination of Forensic Doctors and Scientific Police and the management of the quality control area were the main problems. Despite of the good results achieved, the need for specialised training of the professionals participating in this type of intervention, the need to conduct similar multidisciplinary exercises, and the adaptation of the protocol to the specific guidelines of the Catalan Institute of Legal Medicine was evident(AU)
Subject(s)
Humans , Female , Forensic Anthropology/legislation & jurisprudence , Victims Identification , Forensic Medicine/legislation & jurisprudence , Forensic Medicine/methods , Forensic Anthropology/instrumentation , Forensic Anthropology/organization & administrationSubject(s)
Disasters , Forensic Pathology , Forensic Anthropology , Humans , International Cooperation , ThailandABSTRACT
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