Evaluation of Acute Alcohol Intoxication as the Primary Cause of Death: A Diagnostic Challenge for Forensic Pathologists

J Forensic Sci. 2017 Sep;62(5):1213-1219. doi: 10.1111/1556-4029.13412. Epub 2017 Jan 25.

Abstract

Deaths caused by acute alcohol intoxication (AAI) remain a major public health issue. This study is retrospective and descriptive: an 8-year case analysis of deaths due to AAI in Maryland. Study showed that of 150 AAI deaths, the death rate among Hispanics (10.41/100,000 population) was significantly higher than all the non-Hispanics combined (1.88/100,000 population). The majority of individuals were young adults, overweight, and binge drinkers. The obese group showed significantly lower mean heart and peripheral blood alcohol concentration (BAC) (0.36%, 0.37%) than the normal weight group (0.45%, 0.42%). Based on the PBAC and urine AC ratio, 49.6% deaths likely occurred close to peak phase, followed by postabsorptive phase (31.6%) and absorptive phase (18.8%). Our results indicate that forensic pathologists should evaluate postmortem BAC in the light of individual's age, drinking history, body weight, possible phase of alcohol intoxication, and other autopsy findings when certifying AAI as primary cause of death.

Keywords: acute alcohol intoxication; forensic autopsy; forensic science; forensic toxicology; obesity; postmortem alcohol concentration.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Alcoholic Intoxication / mortality*
  • Binge Drinking / mortality
  • Blood Alcohol Content
  • Body Mass Index
  • Central Nervous System Depressants / analysis
  • Coroners and Medical Examiners
  • Ethanol / analysis
  • Female
  • Humans
  • Male
  • Maryland / epidemiology
  • Middle Aged
  • Overweight / epidemiology
  • Racial Groups / statistics & numerical data
  • Retrospective Studies
  • Sex Distribution
  • Vitreous Body / chemistry
  • Young Adult

Substances

  • Blood Alcohol Content
  • Central Nervous System Depressants
  • Ethanol