Correlation Between Ethanol Concentrations in Postmortem Blood and Vitreous Humor
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Abstract
Background: In forensic autopsy investigations related to traffic accidents, alcohol levels (ethanol) are often implicated. Measuring blood alcohol concentration (BAC) is crucial in determining the cause of death in traffic accident victims, as alcohol levels impact driving ability. However, in cases where post-mortem physiological changes have occurred, vitreous alcohol concentration (VAC) may be a more reliable alternative for determining alcohol levels.
Objective: To investigate the correlation between BAC and VAC in deceased individuals who underwent autopsy within 24 hours postmortem, and to determine the optimal sample collection time for the most accurate measurement of alcohol concentration, given the reliability of VAC in reflecting alcohol levels.
Materials and Methods: This retrospective analytical study reviewed autopsy cases of 108 traffic accident fatalities at Chiang Rai Prachanukroh Hospital between January 2020 and December 2023. Subjects were classified into two groups: those with a BAC-to-VAC ratio greater than 1 (B/V ratio >1) and those with a ratio of 1 or less (B/V ratio ≤1). The correlation between BAC and VAC was analyzed using linear regression analysis. The sample collection time, BAC, and VAC were compared between the two groups using t-tests and the Mann-Whitney U test.
Results: Of the deceased, 92 (85.2%) were male, with a mean age of 38.5±16.5 years (range: 15–75 years). The mean BAC and VAC were 182±107 mg/dL and 192±93 mg/dL, respectively. BAC and VAC showed a very strong correlation (r=0.92, p<0.001). The mean B/V ratio was 1.1±0.2. The B/V ratio >1 group (n=68) had a median sample collection time of 761 minutes (IQR 620, 933 minutes), approximately 12 hours, which was longer than the B/V ratio ≤1 group (n=40) with a median of 525 minutes (IQR 306, 768 minutes, p=0.001). The B/V ratio >1 group also had a higher BAC (214±96 vs. 163±94 mg/dL, p=0.016), while VAC levels were not significantly different (196±92 vs. 183±96 mg/dL, p=0.525).
Conclusion: BAC and VAC have a very strong correlation. Vitreous humor sampling should be considered in addition to blood sampling for cases where the deceased has been postmortem for more than 12 hours to enhance the accuracy of alcohol concentration assessment.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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