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Анализ результатов судебно-медицинских экспертиз трупов, содержащих экзогенный этанол в биологических жидкостях
Every year Russia performs about 700’000 forensic medical examinations and postmortem assessments which is about a third of all deaths. In line with the current legislation, suspected violent deaths (due to external causes) are the reason for a forensic medical exam. Determination of the presence and quantitative content of exogenous ethanol in the corpse’s biological fluids is mandatory in all cases of violent death. In turn, alcohol consumption is one of the leading risk factors affecting mortality in Russia, especially among working-age men. Calculating alcohol consumption in population is challenging, since part of the available alcohol is unregistered (moonshine, alcoholic surrogates), yet there are many indicators that are considered reliable and characterize the level of alcohol consumption in population. This study has attempted to analyze causes of death of those with exogenous ethanol in biological fluids. These indicators are necessary for developing and implementing the most effective health policy, saving health and increasing life expectancy in Russia.
The purpose of the study is to analyze causes of death based on the results of forensic medical examinations of corpses with ethanol in biological fluids.
Material and methods. The material of this paper is data on forensic medical examinations collected by the Russian center of forensic medical examination of the Ministry of Health of the Russian Federation using the statistical observation form #42 “Forensic pathologist’s report, the Burau of forensic medical examination”. The study uses the method of descriptive statistics and correlation analysis. The share of deaths from various causes with ethanol in biological fluids was analyzed based on the results of forensic medical examinations by region and cause of death in 2003-2022.
Results. The share of deaths with ethanol in biological fluids equaled to 46% of all forensic medical examinations in 2003, followed by a gradual decrease to 19% in 2022. The maximum was registered in external causes of death. Over the study period (2003-2022) the share of deaths with ethanol in biological fluids among deaths due to external causes decreased from 60% to 47, and from 31% to 14% among non-violent deaths. The share ranged from 36% to 45% among deaths attributed to symptoms, signs and ill-defined conditions without a tendency towards decreasing. For a number of external causes of death, this indicator consistently accounted for more than half of all forensic medical exams.
Over the period under study, most regions of Russia witnessed a noticeable decrease in the share of deaths with ethanol in biological fluids, however, in some regions like the Republic of Buryatia, Sakhalin Region, Trans-Baikal Territory, Magadan Region, Nenets Autonomous Area and Murmansk Region, there is no noticeable decrease. The minimum was registered in the Chechen Republic and Republic of Ingushetia. However, in the North Caucasian republics, in general, there are low rates of forensic medical examinations of all deaths (less than 10%).
Conclusion. Results of forensic medical examinations can potentially supplement and refine complex estimates of the contribution of alcohol consumption to the Russian mortality.