Strangulation and Its Role in Multiple Causes of Death

Area of Science:

• Forensic Pathology
• Medical Toxicology
• Public Health

Background:

• Forensic pathologists determine cause of death per international guidelines.
• Death certificates may not capture complex cases with multiple contributing factors.
• Strangulation cases can present with additional life-threatening injuries.

Purpose of the Study:

• Examine injury patterns in strangulation cases.
• Identify strangulation deaths with commensurate additional traumatic injuries.
• Assess the need for incorporating multiple causes of death.

Main Methods:

• Retrospective study of strangulation cases (mid-2007 to end-2016).
• Reviewed 43 cases from the Wayne County Medical Examiner's Office.
• Analyzed injury patterns and contributing factors to death.

Main Results:

• 43 strangulation cases identified: 19 ligature, 19 manual, 5 unspecified.
• 63% female, 37% male decedents.
• 14 cases (33%) had multiple causes of death; blunt force trauma was most common.

Conclusions:

• Strangulation deaths frequently involve multiple injuries.
• Blunt force trauma is a significant co-occurring injury in strangulation.
• Female decedents were disproportionately affected in cases with multiple causes.