Differentiating homicidal, suicidal, and autoerotic neck compression deaths

Neck compression occurs when a mechanical force is applied to the anterior or anterolateral aspect of the neck. This can occur in various circumstances, including homicide, suicide, and autoerotic accidents. While forensic medical specialties effectively determine the cause of death in such cases, establishing the manner of death remains challenging. Previous research has highlighted a need for differentiation that goes beyond contextual information and autopsy findings. This study employs epidemiological methods to examine injury prevalence and statistical differentiation of neck compression deaths, aiming to quantify the likelihood of injury across various homicidal, suicidal, and accidental neck compression scenarios. Using data from 266 cases across homicidal ligature and manual strangulation, suicidal neck compression, and autoerotic neck compression, the study investigates injury and associated findings, prevalence, patterns, and probabilities across anatomical regions commonly injured due to neck compression. Results indicate that the odds of injury to various regions of the head and neck are influenced by the manner of death, with homicidal intent often presenting a higher prevalence of injury as well as increased odds of injury. Such statistical differentiation could assist in determining the manner of death in cases of masked homicide, when remains are alternatively preserved, or where there are no reliable witnesses. This research highlights the role of epidemiology in complementing forensic medical specialties, offering quantifiable evidence to assist in medico-legal investigations and expert testimony.