Trisomy 21 in forensic autopsies: Review of a 20-year period.
Accidents
/ mortality
Adolescent
Adult
Age Distribution
Autopsy
/ statistics & numerical data
Cause of Death
Child
Child, Preschool
Down Syndrome
/ epidemiology
Female
Germany
/ epidemiology
Humans
Infant
Infant, Newborn
Infections
/ mortality
Male
Middle Aged
Retrospective Studies
Sex Distribution
Young Adult
Cause of death
Down’s syndrome
Fetocide
Medical malpractice
Vaccination
Journal
Forensic science international
ISSN: 1872-6283
Titre abrégé: Forensic Sci Int
Pays: Ireland
ID NLM: 7902034
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
06
10
2018
revised:
27
01
2019
accepted:
12
02
2019
pubmed:
11
3
2019
medline:
18
4
2019
entrez:
11
3
2019
Statut:
ppublish
Résumé
Trisomy 21 is the most common human chromosomal abnormality. Its manifestation includes intellectual impairment and more or less typical anatomical malformations and functional deficiencies that can cause sudden or unexpected deaths. Typical medicolegal questions at autopsy are related to medical malpractice, improper care, neglect, or abuse, and, depending on the cause of death, whether the death might have been avoidable. The aim of this study was to examine whether the causes of death in individuals with trisomy 21 were linked to the known health risks for this condition and to consider how these deaths might have been prevented. A retrospective study was performed at the Institutes for Legal Medicine in Giessen and Frankfurt am Main, Hesse, Germany. All records for forensic autopsy cases within a 20-year period from 1998 to 2017 were reviewed for the diagnosis trisomy 21", respectively, "Down's syndrome". Twenty-three cases complied with the inclusion criteria trisomy 21 and autopsy. The age of the deceased ranged from 23 days to 61 years. Infectious diseases, mainly respiratory, were the leading cause of death, followed by accidental deaths. The medicolegal relevance of the known health risks in Down's syndrome could be illustrated by the autopsy findings and the results of the additional examinations. The known high susceptibility to infections, with an increased risk of a rapid course and lethal outcome, in individuals with Down's syndrome could be confirmed in our study. A sound knowledge of the risks and abnormalities associated with trisomy 21 are helpful in medicolegal assessments, particularly, in relation to medical malpractice charges.
Sections du résumé
BACKGROUND
BACKGROUND
Trisomy 21 is the most common human chromosomal abnormality. Its manifestation includes intellectual impairment and more or less typical anatomical malformations and functional deficiencies that can cause sudden or unexpected deaths. Typical medicolegal questions at autopsy are related to medical malpractice, improper care, neglect, or abuse, and, depending on the cause of death, whether the death might have been avoidable. The aim of this study was to examine whether the causes of death in individuals with trisomy 21 were linked to the known health risks for this condition and to consider how these deaths might have been prevented.
MATERIAL AND METHODS
METHODS
A retrospective study was performed at the Institutes for Legal Medicine in Giessen and Frankfurt am Main, Hesse, Germany. All records for forensic autopsy cases within a 20-year period from 1998 to 2017 were reviewed for the diagnosis trisomy 21", respectively, "Down's syndrome".
RESULTS
RESULTS
Twenty-three cases complied with the inclusion criteria trisomy 21 and autopsy. The age of the deceased ranged from 23 days to 61 years. Infectious diseases, mainly respiratory, were the leading cause of death, followed by accidental deaths.
CONCLUSION
CONCLUSIONS
The medicolegal relevance of the known health risks in Down's syndrome could be illustrated by the autopsy findings and the results of the additional examinations. The known high susceptibility to infections, with an increased risk of a rapid course and lethal outcome, in individuals with Down's syndrome could be confirmed in our study. A sound knowledge of the risks and abnormalities associated with trisomy 21 are helpful in medicolegal assessments, particularly, in relation to medical malpractice charges.
Identifiants
pubmed: 30852413
pii: S0379-0738(18)30873-9
doi: 10.1016/j.forsciint.2019.02.018
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
302-306Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.