A single-center autopsy study: postmortem diagnosis of hypothermia

Hypothermia is a critical clinical condition characterized by a drop in core body temperature below 35 °C, leading to life-threatening physiological disturbances. The absence of specific and pathognomonic findings in forensic cases complicates diagnosis and necessitates a multidisciplinary evaluation. This study aims to assess hypothermia-related forensic death cases in light of autopsy, toxicological, histopathological, and scene findings. A retrospective review was conducted on 56 cases diagnosed with hypothermia as the cause of death between 01/01/2020 and 31/12/2024. Sociodemographic data, scene investigation reports, external and internal examination findings, radiology (scopy), histopathological and toxicological analyses were evaluated. Descriptive statistics and chi-square test were used, with p < 0.05 considered statistically significant. 94.6% of the cases were male, predominantly young adults. All individuals with available nationality data were foreign nationals. 89.2% were found in rural areas, and 66.1% during the spring season. Wet clothing was observed in 57.1%, and undressing in 42.9%. Scopy was performed in 10.7%. Cold burns and pink-red livor mortis were found in 71.4% and 60.7%, respectively. Gastric erosion was noted in 21.4%, and pulmonary edema in 42.9%. Toxicology revealed psychiatric drugs in 30.4%, and narcotics/volatile substances in 3.6%. Healthcare access was documented in only 5.4%. Autopsy findings alone are insufficient for diagnosing hypothermia. Integrating scene, clinical, and laboratory data enhances diagnostic accuracy. Hypothermia-related deaths should be addressed as public health issues involving medical, socioeconomic, and environmental factors. Standardization of postmortem diagnostic tools and early intervention models for risk groups are recommended.