Medicolegal Autopsies In North Central Nigeria.

Abstract

Objective; To determine the pattern and causes of death reported to the coroner for medicolegal autopsies in North Central Nigeria. Design; A descriptive retrospective study. Setting: Jos University Teaching Hospital,Jos,Nigeria between January 1996 to December 2003. Subjects; Autopsies reports of 279 subjects whose causes of deaths were subjects litigation. Main outcome measures; The causes of death in medicolegal autopsies. Results; A total of 279 cases of medicolegal autopsies with identified causes of death were recorded representing 89% of all the autopsy examination performed within the period. In 7.6% of cases,there was no identifiable cause of death.There were 127 males against 52 females with a male:female ratio of 4.5:1 and their ages ranged between two and 74 years with a mean of 34.7(+/-)8.2 years.Children aged < 15 years made up 29% of the cases and were distributed as follows: 4% of the children were aged 0-5 years,9% between six to ten years while 17% were between 11-15 years.Accidental deaths made up 51% of the cases,homicides 36 % and sudden deaths 13%. Road traffic accidents were responsible for 76% of all accidental deaths and half of them were pedestrians at the time of accident. The male:female ratio of deaths from road traffic accidents was 3:1 with mean age of 24 years. In all the accidental deaths,abdominal injuries were responsible for 47% while 30% died from chest injuries.Of the homicide cases,male subjects outnumbered female in a ratio of 16:1 and children were affected in 28% of homicides. Injuries sustained during ethnic and religious crisis were responsible for 48% of the deaths from homicide and 15% of them were children.Armed robbery was responsible for 28% cases while physical assault were responsible for 20% of homicides.Chest injuries were the causes of deaths in 54% and abdominal injuries in 36% of homicides. Cardiovascular deaths were responsible for 63% cases of all sudden natural deaths referred for coroner's inquest during the period.Children made up of 11% of all sudden natural deaths. Males outnumbered females in cardiovascular deaths in a ratio of 6:1 and 46% of cases of them died of hypertensive heart failure,32% had cerebrovascular accidents,pulmonary embolism in 13.6% and myocardial infarction in 9%. One case of myocardial infarction died during intercourse. Conclusion; Road traffic accidents,violent communal unrest and armed robbery were responsible for 66% of the medicolegal autopsies in our environment. Public enlightenment,good road maintenance and safe driving culture as well as sustainable security for life and property would reduce the incidence of preventable deaths.