Original communicationThe review of autopsy cases of accidental childhood deaths in Istanbul
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
References (34)
- et al.
One-year experience in a regional pediatric trauma center
J Pediatr Surg
(1985) - et al.
Patterns of injury in children
J Pediatr Surg
(1990) - et al.
Drowning-related deaths in New Zealand, 1980–1994
Aust N Z J Public Health
(2001) Accidental childhood death and the role of the pathologist
Pediatr Dev Pathol
(2000)- et al.
Sudden death in infancy, childhood and adolescence
(1994) - et al.
Childhood injurirs: where we are
Pediatrics (Suppl)
(1990) - et al.
Pediatric drowing. A 20-year review of autopsied cases: I.demographic features
Am J Forensic Med Pathol
(2005) - et al.
Excessive rates of childhood mortality in the northern territory, 1985–1994
J Pedaitr Child Health
(1998) Childhood drowing and near drowing in the United States
Am J Dis Child
(1990)- et al.
Drowing and near drowing:a pediatric epidemic
Pediatr Ann
(2000)
Childhood drowning: review of the literature and clinical implications
Pediatr Nurs
Patterns of drowning in Australia, 1992-1997
Med J Aust
Child deaths in Virginia, 1996: a review of investigations of sudden, unexpected, or unnatural deaths of children less than age 13
Am J Forensic Med Pathol
Cocuk olumleri. I. Adli Bilimler Kongre Kitabi, Adana
Child homicide in Cologne (1985–1994)
Foransic Sci Int
Adli Cocuk otopsileri
Adli Tip Bulteni
Cited by (8)
Fatal poisoning of chilhood in the Eastern Black Sea region of Turkey (2009-2013)
2015, Journal of Forensic and Legal MedicineCitation Excerpt :During the 5-year study period (2009–2013), deaths caused by poisoning accounted for 5.9% of all the paediatric autopsies performed in the Eastern Black Sea Region of Turkey. The following rates have been reported in other studies in Turkey: 15.7% by Yayci et al.,9 10.9% by Arslan et al.10 and 8.9% by Butun et al.11 The major toxic agent in the current study was carbon monoxide (64.5%) and this has been reported in other studies at rates of 33.5% by Asirdizer et al.,12 58.1% by Flanagan et al.13 and 18.1% by Campbell et al.14 Carbon monoxide poisoning as the result of unintentional exposure because of water heaters, coal stoves and fires is common in winter in our region.
A prospective study on the profile of accidental childhood fatalities in Central Karnataka
2021, Journal of Punjab Academy of Forensic Medicine and ToxicologyUnnatural deaths among female children and adolescents in Western India
2018, Journal of Indian Academy of Forensic MedicineThe epidemiology of drowning in low- and middle-income countries: a systematic review
2017, BMC Public HealthHead trauma-Related deaths among preschool children in istanbul, Turkey
2016, American Journal of Forensic Medicine and Pathology