apr
Maria Berg von Linde- Institutionen för kliniska vetenskaper, Malmö
Title: A forensic epidemiological approach to stab injuries to the trunk.
Main supervisor: Associate professor Carl Johan Wingren, MD, PhD.
Reviewers: Associate professor Peter Krantz, MD, PhD and Sara Tangmose Larsen, MD, PhD
Abstract
Background
Forensic pathologists are often tasked with determining the likelihood that an injury was inflicted by another person and if the injury would have been fatal if no medical care had been obtained. Victims with a single stab to the trunk are particularly challenging regarding the forensic assessment of causation (assault or self-inflicted) since the injury characteristics can be identified based solely on that single injury. In contrast, determining the fatal injury in a death case or the severity of a certain injury in survivors are generally easier when only studying a population with single stabs to the trunk as potential confounders, e.g., varying numbers of stab wounds in different anatomical locations, are excluded.
Often the fewer the injuries, the more challenging the forensic assessment of manner of death becomes. To guide the assessment in cases of a single fatal stab injury, anatomical distribution and injury characteristics can be identified based solely on that single injury.
Research purpose
The purpose of the project is to apply an epidemiological perspective to single stab injuries in the trunk using characteristics of the victims, injuries and context to increase the scientific support of the forensic assessments in differentiating injuries caused by an assault from self-inflicted injuries, and to define the severity of different stab injuries.
Preliminary results
Homicides were conclusively associated with damage to thoracic bone/cartilage (OR 3.8, 95% CI 1.6-9.0), influence of alcohol (OR 7.1, 95% Cl 2.9-17.7) and illicit drugs (OR 4.3, 95% CI 1.5-11.9). In suicides, both unsurvivable (NISS 75) (66.7% vs 46.8%, p = 0.031) and minor injuries (NISS ≤ 8) (8.9% vs. 0%, p = 0.010) were significantly more common compared to homicidal stabs. We observed a larger proportion of injuries to the heart in suicides (68.9% vs. 46.8%, p = 0.018), while vessel injuries were significantly more common in homicides (52.1% vs. 13.3%, p < 0.001).
Significance
The observed findings could be valuable for forensic assessment of manner of death but also for trauma management as the causation (assault or self-inflicted) might predict which internal injuries that could be expected.
Published study
Berg von Linde M, Acosta S, Khoshnood AM, Wingren CJ.
A Swedish nationwide forensic study of the manner of death in single stab injuries to the trunk. Forensic Sci Int. 2024 Jan;354:111910. doi: 10.1016/j.forsciint.2023.111910. Epub 2023 Dec 10. PMID: 38096751.
Om evenemanget
Plats:
CRC rum 60-13-014
Kontakt:
maria [dot] berg_von_linde [at] med [dot] lu [dot] se