Dataset Information

Forensic autopsies in Norway 1996-2017: A retrospective study of factors associated with deaths undergoing forensic autopsy.

ABSTRACT:

Aims

Forensic autopsies are important for the investigation of deaths with a legal or public-health interest, as well as being a source for cause-of-death statistics. The aim of this study was to investigate the use of forensic autopsies in Norway, with a special emphasis on geographical variation.

Methods

Data from the Norwegian Cause of Death Registry for the years 1996-2017 included 920,232 deaths and 37,398 forensic autopsies. We used logistic regression to identify factors that were associated with the proportion of forensic autopsies, grouped according to the registered cause of death. Explanatory variables were age and sex, place of death, police district, population size and urbanity level of the municipality and distance to the autopsy facility.

Results

The proportion of deaths undergoing forensic autopsy was 4.1%, with the highest being homicides (96.6%) and the lowest being deaths from natural causes (1.7%). Variation between police districts was 0.9-7.8%, and the span persisted during the study period. The most important explanatory variables across the strata were place of death (there were few autopsies of deaths in health-care facilities), police district and age of the deceased. Distance to the autopsy facility, sex, population size and the level of urbanity had only a minor influence. The variation between police districts was not fully accounted for by the other investigated factors.

Conclusions

SUBMITTER: Lycke Ellingsen C

PROVIDER: S-EPMC9152604 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Forensic autopsies in Norway 1996-2017: A retrospective study of factors associated with deaths undergoing forensic autopsy.

Lycke Ellingsen Christian C Alfsen G Cecilie GC Braut Geir Sverre GS

Scandinavian journal of public health 20210308 4

<h4>Aims</h4>Forensic autopsies are important for the investigation of deaths with a legal or public-health interest, as well as being a source for cause-of-death statistics. The aim of this study was to investigate the use of forensic autopsies in Norway, with a special emphasis on geographical variation.<h4>Methods</h4>Data from the Norwegian Cause of Death Registry for the years 1996-2017 included 920,232 deaths and 37,398 forensic autopsies. We used logistic regression to identify factors th ...[more]

PMID: 33685312

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Project description:BackgroundThe investigation into sudden unexpected and unnatural deaths supports criminal justice, aids in litigation, and provides important information for public health including surveillance, epidemiology, and prevention programs. The use of mortality data to convey trends can inform policy development and resource allocations. Hence, data practices/management systems in Forensic Medicine are critical. This study scoped literature and described the body of knowledge on data management and practice systems in Forensic Medicine.MethodsFive steps of the methodological framework of Arksey and O'Malley guided this scoping review. A combination of keywords, Boolean terms, and Medical Subject Headings was used to search PubMed, EBSCOhost (CINAHL with full text and Health Sources), Cochrane Library, Scopus, Web of Science, Science Direct, WorldCat, and Google Scholar from the 18th to 24th of June 2020 and updated in November 2021 for peer review papers. This study included articles involving unnatural deaths, focused on data practice or data management systems, relating to Forensic Medicine, all study designs, and published in English. Screening and selection and data extraction were conducted by two reviews. Thematic analysis was conducted, and the results were reported using both quantitatively and qualitatively.ResultsOf the 23,059 articles, 16 met this study's inclusion criteria. The included articles were published between 2008 and 2019. Eight of the 16 articles were published between 2017 and 2019. Most of the included studies were conducted in the USA (5) and Australia/New Zealand (4). Only two publications were from lower- and middle-income countries (Nigeria, Mexico), and the remaining 14 were from high-income countries (Italy, Denmark, USA, Australia, and New Zealand, Japan, Switzerland, Canada). The data management systems found in this study were as follows: Virtopsy, Canadian Coroner and Medical Examiner Database, Infant Injury Database, Fatal injury surveillance system, Medical Examiners and Coroners Alert System, National Violent Deaths Reporting System, AM/PM Database, Tokyo CDISC/ODM, and National Coronial Information System.ConclusionsThis study's results revealed limited articles relating to data management and practice systems in Forensic Medicine, particularly in LMICs through literature indicating there is a prevalence of unnatural deaths in LMICs. This study, therefore, recommends research on data management and practice systems relating to forensic medicine in LMICs to inform policy decisions.Supplementary informationThe online version contains supplementary material available at 10.1186/s41935-022-00293-3.

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Project description:ImportanceAlthough incidence of suicide in depression varies remarkably temporally, risk factors have been modeled as constant and remain uncharted in the short term. How effectively factors measured at one point in time predict risk at different time points is unknown.ObjectiveTo examine the absolute risk and risk factors for suicide in hospitalized patients with depression starting from the first days after discharge up to 2 years and to evaluate whether the size of relative risk by factor displays temporal patterns over consecutive phases of follow-up.Design, setting, and participantsThis population-based study using Finnish registers (hospital discharge, population, and cause of death registers) included all hospitalizations for depression as the principal diagnosis in Finland from 1996 to 2017, with a maximum follow-up of 2 years. Data were analyzed from January 2022 to November 2023.Main outcomes and measuresIncidence rate (IR), IR ratios, hazard functions, and hazard ratios for suicide by consecutive time periods (0 to 3 days, 4 to 7 days, 7 to 30 days, 31 to 90 days, 91 to 365 days, and 1 to 2 years) since discharge.ResultsThis study included 193 197 hospitalizations among 91 161 individuals, of whom 51 197 (56.2%) were female, and the mean (SD) age was 44.0 (17.3) years. Altogether, patients were followed up to 226 615 person-years. A total of 1219 men and 757 women died of suicide. Incidence of suicide was extremely high during the first days after discharge (IR of 6062 [95% CI, 4963-7404] per 100 000 on days 0 to 3; IR of 3884 [95% CI, 3119-4835] per 100 000 on days 4 to 7) and declined thereafter. Several factors were associated with risk of suicide over the first days after discharge. Current suicide attempt by hanging or firearms increased the risk of suicide most on days 0 to 3 (IR ratio, 18.9; 95% CI, 3.1-59.8) and on days 0 to 7 (IR ratio, 10.1; 95% CI, 1.7-31.5). Temporal patterns of the size of the relative risk diverged over time, being constant, declining, or increasing. Clinical factors had the strongest association immediately. Relative risk remained constant among men and even increased among those with alcohol or substance use disorder.Conclusions and relevanceIn this study, patients hospitalized for depression had extremely high risk of suicide during the first days after discharge. Thereafter, incidence declined steeply but remained high. Within the periods of the highest risk of suicide, several factors increased overall risk manyfold. Risk factors' observed potencies varied over time and had characteristic temporal patterns.

Dataset Information

Forensic autopsies in Norway 1996-2017: A retrospective study of factors associated with deaths undergoing forensic autopsy.

Aims

Methods

Results

Conclusions

Publications

Forensic autopsies in Norway 1996-2017: A retrospective study of factors associated with deaths undergoing forensic autopsy.

Similar Datasets

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