Effects of postmortem interval on postmortem computed tomography findings in bath-related drowning cases

The influence of postmortem interval (PMI) on postmortem computed tomography (PMCT) findings in bath-related drowning remains unclear. This study aimed to identify PMI-susceptible and relatively stable PMCT findings.

Seventy-seven bath-related drowning cases met the eligibility criteria. To minimize the potential influence of resuscitation-related artifacts, the primary analysis was performed in 72 cases after excluding five hospital-transported cardiopulmonary arrest cases with documented pre-PMCT resuscitative intervention. Quantitative PMCT findings were assessed using Spearman's rank correlation; Group A (PMI <24 h) and Group B (PMI ≥24 h) were compared using the Mann-Whitney U test for continuous variables and Fisher's exact test for categorical variables. Multivariable regression analyses adjusted for age and sex were also performed.

The sphenoid sinus-fluid volume, gastric-fluid volume, and ethmoid sinus-fluid accumulation showed no significant associations with the PMI after adjustment for age and sex. In contrast, the pleural effusion volume, anterior mediastinal distance, right diaphragm level, splenic attenuation, total stomach volume, and gastric-air volume remained significantly associated with the PMI after adjustment for age and sex. The association of maxillary sinus-fluid volume with the PMI in the univariable analysis lost significance after adjustment for age and sex.

Within the range of PMI examined in this study, the sphenoid sinus-fluid volume, ethmoid sinus-fluid accumulation, and gastric-fluid volume showed no significant associations with the PMI after adjustment for age and sex and may represent relatively stable findings across different PMIs.