This article reports on a study of the diagnostic ability of postmortem computed tomography (PMCT) in cases of fatal trauma after traffic accidents. The authors note that the autopsy rate of traffic accident-related deaths in Japan is only about 5% even though most traffic accident deaths are due to non-penetrating injuries. Approximately 90% of emergency hospitals in Japan have been using PMCT as a substitute when autopsy is unattainable. The study included 78 subjects (59 males, 19 females; mean age 50 years,range 15-87 years) who were brought to the authors' institution in cardiopulmonary arrest on arrival after traffic accidents and died despite resuscitation attempts. The authors classified the PMCT findings of damage to the head, neck, thorax, abdomen, and pelvis into three grades according to the Abbreviated Injury Scale (AIS) severity. The percentage ratio of minor/serious/maximum in 78 head injuries was 32/60/8, in 41 neck injuries was 83/5/12, in 76 thorax injuries was 5/38/57, in 76 abdominal injuries was 70/24/7, and in 76 pelvic injuries was 79/21/0, respectively. Because of its noninvasive nature, consent for PMCT examination agreement was obtained from all patient families, in contrast to only one case of autopsy consent. The authors conclude that PMCT can be used to detect or presume fatal trauma when diagnosing the cause of death after traffic accidents.
Abstract