Drowning and forensic medical process in Türkiye: The retrospective analysis on 989 autopsied cases in 5 years

Drowning is the third leading cause of unintentional injury-related deaths worldwide, claiming around 236,000 lives annually. In Türkiye, with its extensive coastlines and freshwater resources, drowning is a significant public health concern as well. This study retrospectively examines 989 autopsied drowning cases in Türkiye between 2015 and 2019. It highlights the prevalence of drowning, showing that most victims were male (83.8 %), with a median age of 27. The results indicated a predominance of young males in saltwater drownings, while females were more frequently victims in freshwater incidents, indicating sex-specific risks. The study found that in 91.8 % of cases, the cause of death was solely drowning, while 5.1 % involved contributing factors such as cardiovascular disease. Histopathological findings revealed acute lung swelling and edema in 67.5 % of cases, with a prevalence of frothy fluid at the mouth/nostrils and water immersion wrinkling of the hands and feet being notably higher in freshwater drownings. The study also revealed statistically significant differences in lung and organ weights between saltwater and freshwater drowning victims, emphasizing the physiological differences in response to the two environments. The role of alcohol and drugs was identified in a minority of cases (5.8 %), highlighting the importance of substance use as a contributing risk factor. Determining whether a death was due to drowning or other causes (e.g., injury, disease, or hypothermia) poses significant challenges for forensic experts. Environmental factors, decomposition, and delayed recovery further complicate investigations. The research emphasizes the need for improved forensic techniques to enhance the understanding of drowning fatalities.