Application of the drowning index to actual drowning cases

Sugimura, Tomoko; Kashiwagi, Masayuki; Matsusue, Aya; Hara, Kenji; Kageura, Mitsuyoshi; Kubo, Shin-ichi

doi:10.1016/j.legalmed.2009.11.006

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Volume 12, Issue 2 , Pages 68-72, March 2010

Application of the drowning index to actual drowning cases

Tomoko Sugimura
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
Masayuki Kashiwagi
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
Aya Matsusue
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
Kenji Hara
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
Mitsuyoshi Kageura
- General Medical Research Center, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
Shin-ichi Kubo
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Corresponding author. Address: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. Tel.: +81-92-801-1011x3330; fax: +81-92-801-4266.

Received 26 June 2009; received in revised form 12 November 2009; accepted 15 November 2009. published online 28 January 2010.

Abstract

The drowning index (DI) was devised to diagnose drowning deaths, and is the weight ratio of the lungs and pleural effusion to the spleen. Among drowning (94 cases), mechanical asphyxia (47 cases), and acute cardiac (42 cases) deaths, within 2weeks postmortem we compared six markers, the weight of each lung, pleural effusion weight, total weight of the lungs and pleural effusion, spleen weight, heart weight, and the DI. Statistical analysis revealed that the total weight was heavier, while spleen weight was lighter, and the DI was significantly larger in the drowning group (p<0.05). We examined the relation between the postmortem time and these markers. We divided 94 drowning cases into three groups according to the postmortem duration, group A (0–3days; 43 cases), group B (3–7; 29 cases), and group C (7–14; 22 cases). The cut-off point of the DI was analyzed using the receiver operating characteristic (ROC) curve. As a result, the DI cut-off point was 14.1 in cases within two postmortem weeks. Drowning is still a difficult autopsy diagnosis, but in our experience, DI is a valuable indicator.