Original communication
The review of autopsy cases of accidental childhood deaths in Istanbul

https://doi.org/10.1016/j.jflm.2011.04.009Get rights and content

Abstract

Children are at increased risk for various causes of injury from accidents. Accidents are, by far, the leading cause of death among children and adolescents. The aim of this study is to evaluate the lethal childhood accidents in İstanbul by age groups. Reports of autopsies performed between 2001 and 2005 in the Morgue Department of the Council of Forensic.

Medicine in Istanbul (n :16853) are examined retrospectively. 833 deaths from accidents in children aged 0–18 years are investigated into the study. The parameters of age, gender, types of accidents and causes of death are evaluated. The accidents account for 47.3% of the deaths among children aged 0–18 years. Of 833 cases, 601 (73%) are male and 232 (27%) are female. The female to male ratio is 1/2.6. The highest rate of death from accidents is at the group of 15–18 years. The primary causes of accidental childhood deaths are motor vehicle accidents (23.1%), followed by drowning (20,1%), poisoning (15.7%), and fall from height (15.5%). The incidence and types of trauma vary with socio-economic status and culture. İstanbul, where this study is conducted in, has approximately 3000 autopsy number annually. Therefore, it provides an important database.

Introduction

Children are at increased risk for various causes of injury from accidents. The infant and the child are unable to avoid from potentially dangerous positions that may not present a danger to an adult. This is the result of having poor physical strength, small body corpus, difficulty in coordination and being inexperience. Accidents account for most sudden deaths in childhood and adolescence.1 In the United States, where childhood injury rates are high, accidents are responsible for nearly 50% of deaths in the age range of 1–24 years, and 71% of deaths between the ages of 15 and 19 years.2 Although the percentages for the different categories vary among studies, common causes of accidental death of children are crashes, drowning and fires/burns.2, 3, 4 Crashes in the USA are most frequently caused by drunk drivers.5 Drowning is the second most common cause of accidental death in infancy and childhood, ranking behind crashes, and is the leading cause of death in children under the age of 5 in Australia and parts of the United States.6, 7, 8 In most series, males outnumber females and children most at risk are pre-scholars 0–4 years old, adolescent males 15–18 years old.9, 10, 11, 12

For children under 1 years of age, accidental mechanical asphyxia is a significant cause of preventable deaths. Byard reported that accidental asphyxia due to unsafe sleeping circumstances is 11%.1

Types of injuries vary with location –urban and rural- and socio-economic status. The morbidity and mortality data related with accidents in childhood helps to prepare prevention programs. The aim of this study is to evaluate the lethal accidents in childhood in Istanbul by age groups.

Section snippets

Materials and methods

The autopsy reports of the Morgue Department of Council of Forensic Medicine in Istanbul between 2001–2005 (n: 16853) are evaluated retrospectively. There are 1761 autopsy cases aged 0–18 years between 2001 and 2005. The origin of death classified as accident, homicide, suicide, natural and unknown is evaluated based on legal investigations, autopsy reports and laboratory results. 833 of the deaths from accident are included in this study. The cases are assigned into the age groups, 0–12

Results

There are 833 child autopsies from accidental deaths in Istanbul for five years. Accidents account for 47.3% of the deaths among children aged 0–18 years.

Of 833 cases, 601 (73%) are male and 232 (27%) are female. The female to male ratio is 1/2.6.

Table 1 shows the accidents by age groups and gender. The primary cause is the crashes (23.1%) (Table 1).

Of all deaths from crashes, 26% are female, 74% are male and 30.1% are aged 5–9 years. Of all cases of drowning, 15% are female, 85%are male and

Discussion

According to data from the Turkish Statistics Institute, only 14% of the children aged 0–18 years died of accidents by 2005. This ratio is attributed to high rates of natural deaths in Turkey. Since the study sample included autopsies requested by the legal authorities, the rate of deaths from accidents is high in this study as 47.3% between 2001 and 2005. Maloney et al. reported 42.2% of the deaths at the age of 0–12 years to be caused by accidents.13

Boys are involved in 73% of the cases. This

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