Elsevier

Legal Medicine

Volume 5, Supplement, March 2003, Pages S344-S346
Legal Medicine

Inquest results on the aged: comparison between Mie Prefecture and three Medical Examiners’ Offices in Japan

https://doi.org/10.1016/S1344-6223(02)00168-2Get rights and content

Abstract

In Japan, the medical examiner system was enforced only in three large cities, Tokyo metropolitan, Osaka and Kobe Cities. In other areas without this system, autopsy rates are much lower than in the areas with the system. Since the population of the aged (≧65 years old) has been increasing recently, the subjects for medicolegal investigations seem to be also increasing. In the present study, between Mie Prefecture and those three Medical Examiner's Offices in Japan, the inquest results during the 5-year-period from 1996 to 2000, especially on the aged, were compared. The aged accounted for approximately 50% of all inquest cases in those areas. Autopsy rates for the aged were 16, 24 and 75% in Tokyo, Osaka and Kobe, respectively. Seventy-five to eighty percent was classified in deaths due to disease. Seventy to seventy-five percent of death due to disease was subclassified in circulatory diseases. The highest incidence of vascular diseases was observed in Kobe whose autopsy ratio was the highest. On the contrary, ambiguous causes of deaths, e.g. heart failure or unknown, were still frequent in Mie Prefecture.

Introduction

In Japan, the medical examiner system was enforced only in three large cities, Tokyo metropolitan, Osaka and Kobe Cities. In these areas, any unnatural deaths are examined by professional medical examiners, and medico-legal autopsies are performed, if necessary. Furthermore, the results are published in annual reports. Autopsy rates in other areas without the medical examiner system are somewhat lower than the areas with the system. As the population of the elderly (≧65 years old) has been increasing recently, the subjects for medicolegal investigations seem to be increasing as well. In the present study, the inquest results, especially for the aged, during the 5-year-period from 1996 to 2000 were compared between Mie Prefecture and those Medical Examiner's Offices in Japan [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15].

Section snippets

Materials and methods

Inquest records in Mie Prefecture during the period 1996–2000 were obtained through Mie Prefecture Police Headquarters. Causes of deaths of 6036 medicolegal cases were classified under the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes [16]. Especially for the aged (≧65 years old), the standardized mortality ratio (SMR) of each cause-of-death was compared those in the three large cities mentioned above.

Results and discussion

The numbers of inquest cases in Mie Prefecture and three Medical Examiners’ Offices are summarized in Table 1.

In Mie Prefecture, 213 cases among 6036 inquest cases were autopsied over the past 5 years (3.5%). The population of elderly (≧65 years old) has been increasing in Japan. Standardized inquest ratios (Tokyo 1996=1.0) for the aged are shown in Table 2. The ratio of inquest cases was higher in urban areas than in local areas. The aged accounted for approximately 50% of all inquest cases in

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