Sudden and violent death structure in Latvia (1999-2000).

Histological laboratory of the State Forensic Medicine Centre has possibility to provide examination of histological object what are sent by forensic pathologists from all regions of Latvia. Following this, we investigated death structure during last two years (from 1999-2000). Head trauma among cause of violent death prevailed and one third of them consist trauma with tissue surviving. Trauma of other parts of body or combination of trauma, death caused by poisoning, drawning and cold were common.

Introduction

The aim of our investigation was to detect frequency of violent death and death caused by several diseases, taking into consideration sex and age of the dead.

Materials and methods

Tissue has been coloured according to histological hematoxilin - eozin and sequential histochemistry methods: PAS reaction, Sudan, Azureozin, orange - red - blue by Zerbino.

Results and discussion

During the last two years (1999-2000) Histology Laboratory of State Forensic Medicine Expertise Centre has carried out the examination of 7073 histological cases.

There has been 3491 such a case in 1999, 3546 cases - in 2000 year.

There have been 2309 cases of violent death in 1999, in year 2000 their number has decreased and makes 1895 cases, however the number of deaths caused by different diseases has increased to 469 cases in year 2000. In 1/3 of the cases head trauma with tissue survival predominates among violent deaths.

Table 1. Head trauma in 1999-2000

We have stated that during 2000 the number of traumas has increased in almost all the gradations of the age. The stress is laid on the age 40 to 50, moreover, the representatives of masculine gender suffer three times more than women. The other traumas are added up by different bodily injuries or the latter are combined with head trauma.

Table 2. Total trauma in 1999-2000

During the year 2000 the number of these cases increased by to 24, the accidents with men happen more often than with women, the dominating age is 50 years. The great amount of traumatism can be explained, firstly, by the development of vehicle industry; secondly, there are many old cars in Latvia; thirdly, drivers drive being under influence of alcohol or they drive negligently. The attention is diverted by the use of mobile phones during driving and, lastly, the pedestrians do not observe traffic rules as well.

The second place after head traumas is taken by mechanic asphyxia.

Table 3. Dependence of mechanical asphyxias from age and gender in 1999-2000

Table 4. Drowning cases depending on age and gender in 1999-2000

Compression and strangulation asphyxia is followed by obturation asphyxia - drowning.

The year 2000 prevails with a small preponderance, moreover, the largest number is made by men at the age between 40 and 50. During the last year women have drowned more often being at the age of 60. Intoxication is the next largest group, where alcoholic intoxication prevails followed by drugs' overdose. Showings of the last year and 1999 are almost on the same level, there is no difference between ages as well, but the dead being comparatively young, i.e., in the range between 20 and 40 years, as refers to the year 2000.

The above mentioned intoxication with carbon monoxide follows at once, that can be explained partially by the great number of cars in the country that are used being under the influence of alcohol, besides there are many old houses, where firewood heating is used.

Freezing to death category is the next to come.

Table 5. Death of freezing in Latvia in 1999-2000

There are 10 cases more in 2000 than in 1999, i.e., 120 cases that make 3.4% of all the mortality, but in 1999 - 110 cases that make 3%. The age ranges between 45 and 50, on average, and the predominating gender is the masculine one.

Burns follow afterwards. There are 3 more cases in the year 2000 than in 1999?- 31 and 34 cases. Septicaemia and septicopiemia play the main role in thanatogenesis.

A small percentage of violent deaths is made by electrotrauma. In 1999 there have been 6 cases, in 2000 - 5. There have been no cases of survival during the last year.

Table 6. Death due to heart ischaemic disease in Latvia in 1999-2000

Within category of reasons of adults' sudden death the main place is taken by mortality caused by heart coronary disease, on the background of hypertonia or atherosclerosis, it is 75% of non-violent deaths. There are proportionally high showings in both the years, in 1999 there are 35 cases less. Myocardial infarction is encountered more often with men of the age between 40 and 60.

Showings of the feminine gender are almost on the same level, just 1 case more in the year 2000.

Heart coronary disease are followed by diseases of respiratory organs, making 5-7%, among them the first place is taken by tuberculosis, moreover, the number of acute forms increases among young people.

Table 7. Death due to lung tuberculosis in 1999 (male - 39; female - 6); 2000 (male?- 48; female - 5)

Showings of the years that have been analysed hardly differ in respect to the number of diseases, and generally people of middle age get ill. There is no sharp difference in respect to the showings about men and women. During the latter year 1/3 has died with a form of active infiltrate lungs' tuberculosis.

Pneumonia should be mentioned among the other respiratory diseases, it is encountered at any age. Bronchectatic and chronic obstructive lungs' disease concerns middle-aged and old people more, with complications such as lungs' bleeding and decompensation of lungs and heart.

Chronic ulcers with bleeding or perforation, causing peritonitis, should be mentioned among gastric - intestine tract diseases.

During these years toxic form of influenza that vacillates between 1% and 2%, causing extensive haemorrhages, haemorrhagic pneumonia and oedema of larynx, should be mentioned among infectious diseases.

Chronic alcoholism is almost on the same level in 1999 and 2000 - 49 and 50 cases. Outbreaks of diseases, disturbances of brain functions, decompansated liver cirrhosis and active cardiomyophatia cause death.

Malignant tumours with different localisation make 1%, on average, of our examinations. Mortality of the new-borns makes 0.3%, on average, in 1999 its number is 11, in year 2000 - 14.

In diagnostics perinatal asphyxia and intrauterine infections, as well as birth traumas, when delivery takes place outside lying in hospital, take the main role in thanatogenesis of new-borns.

Conclusion

In comparison with other previous years the number of traumas is increasing. In the group of non-violent deaths heart pathology prevails and the active forms of tuberculosis grow.

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