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Clotted blood as sign of alcohol intoxication: a retrospective study

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Abstract

A total of 138 autopsies performed at the Institute of Legal Medicine of the University of Münster between 1994 and 2006 were subdivided into two groups: (1) 69 asphyxial deaths with a blood alcohol level (BAL) > 1‰ and (2) 69 asphyxial deaths with a BAL of 0.00‰. The coagulation state in the central vessels was registered in all cases as fluid, compactly clotted or loosely clotted, and the post-mortem interval was recorded. Histology investigations were performed on the liver to analyze the incidence of hepatic fibrosis/cirrhosis. Fisher’s exact test was performed to check for statistical significance. The blood was found to be clotted in 49.3% of the cases of group (1) and in 5.8% of group (2) (p < 0.01). The post-mortem interval did not have any influence on the coagulation state as observed in both groups. Liver fibrosis/cirrhosis was a rare finding detected in three cases in group 1 and in two cases in the control group 2 and, therefore, not relative to our observations. A distinctly positive BAL is often associated with heavy stages of blood coagulation as observed during autopsy. Distinctly positive alcohol concentrations have an influence on the fibrinolytic process and, hence, on the coagulation status.

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References

  1. Schloegl H, Dresen S, Spaczynski K, Stoertzel M, Wurst FM, Weinmann W (2006) Stability of ethyl glucuronide in urine, post-mortem tissue and blood samples. Int J Legal Med 120:83–88

    Article  PubMed  Google Scholar 

  2. Koski A, Vuori E, Newer I (2005) Antidepressants: evaluation of fatal toxicity index and interaction with alcohol based on Finnish postmortem data. Int J Legal Med 119:244–248

    Article  Google Scholar 

  3. Hoiseth G, Kristoffersen L, Larssen B, Arnestad M, Hermansen NO, Morland J (2007) In vitro formation of ethanol in autopsy samples containing fluoride ions. Int J Legal Med 121:85–89

    Article  Google Scholar 

  4. Boumba VA, Ziavrou KS, Vougiouklakis T (2007) Biochemical pathways generating post-mortem volatile compounds co-detected during forensic ethanol analyses. Forensic Sci Int (in press). DOI 10.1016/j.forsciint.2007.03.018

  5. Huckenbeck W, Bonte W (2003) Sektionsbefund bei Alkoholvergiftung und chronischem Missbrauch. In: Madea B, Brinkmann B (Hrsg ) (ed) Handbuch Gerichtliche Medizin, Band II. Springer, Berlin Heidelberg New York, p 427

    Google Scholar 

  6. Mueller B (1953) Tödliche Alkoholvergiftung. In: Mueller B (Hrsg) Gerichtliche Medizin. Springer, Berlin Heidelberg New York, pp 773–774

    Google Scholar 

  7. Brettel H-F (1986) Die tödliche Alkoholvergiftung. In: Forster B (Hrsg) Praxis der Rechtsmedizin. Georg Thieme, Stuttgart, Germany, pp 466–467

  8. Prokop O (1976) Die tödliche Alkoholvergiftung und plötzliche Todesfälle bei Alkoholikern. In: Prokop O, Göhler W (Hrsg) Forensische Medizin. Fischer, Stuttgart, Germany, pp 369–370

  9. Maxeiner H (2003) Gewaltsame Erstickung. In: Madea B (ed) Praxis rechtsmedizin. Springer, Berlin Heidelberg New York, pp 147–152

    Google Scholar 

  10. Adebahr G (1969) Der forensische Beweiswert von Befunden an der Leiche. Beitr Gerichtl Med 25:44–50

    PubMed  CAS  Google Scholar 

  11. Desmet VJ, Gerber M, Hoofnagle JH, Manns M, Scheuer PJ (1994) Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 19:1513–1520

    PubMed  CAS  Google Scholar 

  12. Weiler G, Adebahr G, Klöppel A (1980) Zum diagnostischen Wert von “geronnenem” Herzblut bei akutem Erstickungstod. Z Rechtsmed 85:23–27

    Article  PubMed  CAS  Google Scholar 

  13. Mukamal KJ, Jadhav PP, D’Agostino RB et al (2001) Alcohol consumption and hemostatic factors: analysis of the Framingham offspring cohort. Circulation 104:1367–1373

    Article  PubMed  CAS  Google Scholar 

  14. Mukamal KJ, Massaro JM, Ault KA et al (2005) Alcohol consumption and platelet activation and aggregation among women and men: the Framingham offspring study. Alcohol Clin Exp Res 29:1906–1912

    Article  PubMed  CAS  Google Scholar 

  15. Dakeishi M, Iwata T, Ishii N, Murata K (2004) Effects of alcohol consumption on hepatocellular injury in Japanese men. Tohoku J Exp Med 202:31–39

    Article  PubMed  CAS  Google Scholar 

  16. Baysan O, Kaptan K, Erinç K et al (2005) Chronic heavy ethanol consumption is associated with decreased platelet aggregation in rats. Tohoku J Exp Med 206:85–90

    Article  PubMed  CAS  Google Scholar 

  17. Brecher AS, Adamu MT (2001) Coagulation protein function: enhancement of the anticoagulant effect of acetaldehyde by sulfated glycosaminoglycans. Dig Dis Sci 46:2033–2042

    Article  PubMed  CAS  Google Scholar 

  18. Basista MH, Joseph A, Smolen S, Koterba A, Brecher AS (1994) Acetaldehyde alters coagulation protein function. Dig Dis Sci 39:2421–2425

    Article  PubMed  CAS  Google Scholar 

  19. Brecher A, Koterba AP, Basista MH (1996) Coagulation protein function. III. Effect of acetaldehyde upon the activation of prothrombin. Alcohol 13:423–429

    Article  PubMed  CAS  Google Scholar 

  20. Brecher AS, Koterba AP, Basista MH (1996) Coagulation protein function. IV. Effect of acetaldehyde upon factor X and Xa, the proteins at the gateway to the common coagulation pathway. Alcohol 13:539–545

    Article  PubMed  CAS  Google Scholar 

  21. Brecher AS, Hellman K, Dulin C, Basista MH (1998) Coagulation protein function. V. Diminution of antithrombin III function by acetaldehyde. Dig Dis Sci 43:1746–1751

    Article  PubMed  CAS  Google Scholar 

  22. Sabol DA, Basista MH, Brecher AS, Haider K, Kleshinski J (1999) Coagulation protein function. VII. Diametric effects of acetaldehyde on factor VII and factor IX function. Dig Dis Sci 44:2564–2567

    Article  PubMed  CAS  Google Scholar 

  23. Brecher AS, Adamu (2002) MT short- and long-term effects of acetaldehyde on plasma. Alcohol 26:49–53

    Article  PubMed  CAS  Google Scholar 

  24. Hansagi H, Romelsjö A, Gerhardsson de Verdier M, Andreasson S, Leifman A (1995) Alcohol consumption and stroke mortality. Stroke 26:1768–1773

    PubMed  CAS  Google Scholar 

  25. Booyse FM, Parks DA (2001) Moderate wine and alcohol consumption: beneficial effects on cardiovascular disease. Thromb Haemost 86:517–528

    PubMed  CAS  Google Scholar 

  26. Murray RP, Connett JE, Tyas SL, Bond R, Ekuma O, Silversides CK, Barnes GE (2002) Alcohol volume, drinking pattern and cardiovascular disease morbidity and mortality: is there a U-shaped function? Am J Epidemiol 155:242–248

    Article  PubMed  Google Scholar 

  27. Davidson DM (1989) Cardiovascular effects of alcohol. West J Med 151:430–439

    PubMed  CAS  Google Scholar 

  28. Numminen H, Syrjälä M, Benthin G, Kaste M, Hillbom M (2000) The effect of acute ingestion of a large dose of alcohol on the hemostatic system and its circadian variation. Stroke 31:1269–1273

    PubMed  CAS  Google Scholar 

  29. Sasaki A, Kurisu A, Ohno M, Ikeda Y (2001) Overweight/obesity, smoking and heavy alcohol consumption are important determinants of plasma PAI-1 levels in healthy men. Am J Med Sci 322:19–23

    Article  PubMed  CAS  Google Scholar 

  30. Patrono C, Ciabattoni G, Pugliese F, Pierucci A, Blair IA, FitzGerald GA (1986) Estimated rate of thoromboxane secretion into the circulation of normal humans. J Clin Invest 77:590–594

    Article  PubMed  CAS  Google Scholar 

  31. Catella F, FitzGerald GA (1987) Paired analysis of urinary thromboxane B2 metabolites in humans. Thromb Res 47:647–656

    Article  PubMed  CAS  Google Scholar 

  32. Van de Wiel A, van Golde PM, Kraaijenhagen RJ, von dem Borne PAK, Bouma BN, Hart HC (2001) Acute inhibitory effect of alcohol on fibrinolysis. Eur J Clin Invest 31:164–170

    Article  PubMed  Google Scholar 

  33. De Lange DW, Hijmering ML, Lorsheyd A, Scholman WLG, Kraaijenhagen RJ, Akkerman JWN, van de Wiel A (2004) Rapid intake of alcohol (binge drinking) inhibits platelet adhesion to fibrinogen under flow. Alcohol Clin Exp Res 28:1562–1568

    Article  PubMed  Google Scholar 

  34. Collins GB, Brosnihan KB, Zuti RA, Messina M, Gupta MK (1992) Neuroendocrine, fluid balance, and thirst response to alcohol in alcoholics. Alcohol Clin Exp Res 16:229–233

    Google Scholar 

  35. Parlesak A, Pohl C, Bode JC, Bode C (2004) Water metabolism in rats subjected to chronic alcohol administration. Nephron Physiol 97:9–15

    Article  CAS  Google Scholar 

  36. Marsano L, McClain CJ (1989) Effects of alcohol on electrolytes and minerals. Alcohol Health and Research World, US Government Printing Office, USA

  37. Berg SP (1950) Das postmortale Verhalten des Blutes. Z Gerichtl Med 40:1–75

    Article  CAS  Google Scholar 

  38. Berg S (1963) Physiologisch-chemische Befunde im Leichenblut als Ausdruck des Todesgeschehens. Z Gerichtl Med 54:136–149

    Article  CAS  Google Scholar 

  39. Tacheiki S, Wakasugi C, Shikata I (1984) Fluidity of the blood after sudden death: Part I. Am J Forensic Med Pathol 5:223–227

    Article  Google Scholar 

  40. Tacheiki S, Wakasugi C, Shikata I (1985) Fluidity of the blood after sudden death: Part II. Am J Forensic Med Pathol 6:25–29

    Article  Google Scholar 

  41. Tacheiki S, Tokunaga I, Hayakumo K, Maeiwa M (1986) Fluidity of the blood after sudden death: Part III. Am J Forensic Med Pathol 7:35–38

    Article  Google Scholar 

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Authors and Affiliations

  1. Institute of Legal Medicine, University of Münster, Röntgenstraße 23, 48149, Münster, Germany

    T. Fracasso, B. Brinkmann, J. Beike & H. Pfeiffer

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  1. T. Fracasso
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  2. B. Brinkmann
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  3. J. Beike
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  4. H. Pfeiffer
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Correspondence to T. Fracasso.

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Fracasso, T., Brinkmann, B., Beike, J. et al. Clotted blood as sign of alcohol intoxication: a retrospective study. Int J Legal Med 122, 157–161 (2008). https://doi.org/10.1007/s00414-007-0185-3

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  • DOI: https://doi.org/10.1007/s00414-007-0185-3

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