Summary statistics for drugs and alcohol concentration recovered in post-mortem femoral blood in Western Switzerland.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_8C70B8F9DC3B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Summary statistics for drugs and alcohol concentration recovered in post-mortem femoral blood in Western Switzerland.
Journal
Forensic science international
Author(s)
Lefrancois E., Reymond N., Thomas A., Lardi C., Fracasso T., Augsburger M.
ISSN
1872-6283 (Electronic)
ISSN-L
0379-0738
Publication state
Published
Issued date
24/06/2021
Peer-reviewed
Oui
Volume
325
Pages
110883
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
In post-mortem investigations of fatal intoxication, it is challenging to determine which drug(s) were responsible for the death, and which drugs did not. This study aims to provide post-mortem femoral blood drug levels in lethal intoxication and in post-mortem control cases, where the cause of death was other than intoxication. The reference values could assist in the interpretation of toxicological results in the routine casework. To this end, all post-mortem toxicological results in femoral blood from 2011 to 2017 in Western Switzerland were considered. A full autopsy with systematic toxicological analysis (STA) was conducted in all cases. Results take into account the cause of death classified into one of four categories (as published by Druid and colleagues): I) certified intoxication by one substance alone, IIa) certified intoxication by more than one substance, IIb) certified other causes of death with incapacitation due to drugs, and III) certified other causes of death without incapacitation due to drugs. This study includes 1 990 post-mortem cases where femoral blood was analysed. The material comprised 619 women (31%) and 1 371 men (69%) with a median age of 50 years. The concentrations of the 32 most frequently recorded substances as well as alcohol are discussed. These include 6 opioids and opiates, 3 antidepressants, 6 neuroleptics and hypnotics, 1 barbiturate, 11 benzodiazepines (and related drugs), 2 amphetamine-type stimulants, cocaine, paracetamol, and tetrahydrocannabinol (THC). The most common substances that caused intoxication alone were morphine, methadone, ethanol, tramadol, and cocaine. The post-mortem concentration ranges for all substance are categorized as I, IIa, IIb, or III. Statistical post-mortem reference concentrations for drugs are discussed and compared with previously published concentrations. This study shows that recording and classifying cases is time-consuming, but it is rewarding in a long-term perspective to achieve a more reliable information about fatal and non-fatal blood concentrations.
Keywords
Pathology and Forensic Medicine, Benzodiazepine, Drugs, Intoxication, Medicine, Post-mortem toxicology
Pubmed
Open Access
Yes
Create date
24/06/2021 21:12
Last modification date
08/07/2021 6:36
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