The Impact of Discontinuation of the Medical Examiner System: Cases of Drowning in the Bathtub at Home
The Impact of Discontinuation of the Medical Examiner System: Cases of Drowning in the Bathtub at Home
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DOI：
10.1111/1556-4029.14251
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发表时间：
2020-05-01
影响因子：
1.6
通讯作者：
Osawa, Motoki
中科院分区：
文献类型：
--
作者：
Kakiuchi, Yasuhiro;Nagao, Ryoko;Osawa, Motoki
日本不同县的溺水死亡发生率差异很大，主要是由于气候差异。然而，除了气候之外，可能还有其他因素影响死亡发生率，例如地区死亡调查系统的差异。在这里，我们的目的是阐明影响浴缸溺水死亡率数据的其他因素，特别是终止体检系统的影响。使用了京都的警方数据和横滨的门诊信息。获得了 2014 年至 2015 年冬季老年人在家中浴缸中死亡或死亡的病例数据。为每个病例收集以下数据：年龄、性别、是否有流动交通、尸检的进行以及死亡原因。京都的尸检率和溺水率均为 0%，而横滨的尸检率和溺水率均明显较高，分别为 93.1% 和 89.4%（每个比率的分母是每年冬季每个城市在家里的浴缸中发现垂死或死亡的老年人（65 岁或以上）总数）。尽管与沐浴相关的总死亡发生率没有显着差异，但横滨与溺水相关的死亡比例却明显高于京都。这种差异可归因于两个城市之间尸检率的差异，这主要是由是否存在法医系统造成的。因此，我们应该密切关注横滨市尸检/溺水率未来的变化，并确定这一变化是否会因该制度的废除而持续受到影响。
The incidence of death by drowning greatly varies among different prefectures in Japan, mainly due to climate difference. However, there could be other factors affecting the incidence of deaths besides climate, for example, differences in regional death investigation systems. Here, we aimed to elucidate other such factors affecting the mortality data of drowning in the bathtub, especially the effects of discontinuing the medical examiner system. Police data in Kyoto and ambulatory care information in Yokohama were used. Data on cases of elderly individuals found dying or dead in the bathtub at home in winter 2014-2015 were obtained. The following data were collected for each case: age, gender, presence/absence of ambulatory transport, performance of autopsy, and cause of death. The autopsy and drowning rates in Kyoto were 0%, whereas both values in Yokohama were significantly higher at 93.1% and 89.4%, respectively (the denominator of each of the rates is the total number of elderly (aged 65 or over) individuals found dying or dead in the bathtub at home in each city during each winter). Despite no significant difference of incidence of total bath-related death, the proportion of drowning-related deaths was overwhelmingly higher in Yokohama than in Kyoto. The difference can be attributed to the difference in autopsy rates between the two cities, mainly caused by the presence/absence of a medical examiner system. Therefore, we should pay careful attention to future changes in autopsy/drowning rates in Yokohama, and ascertain whether the change might be continuously influenced by the abolishment of this system.