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Asphyxia homicides in Denmark 1992–2016

Abstract

In this retrospective study , we present the findings in 250 homicides by asphyxia in Denmark in a 25-year period, with a particular focus on the autopsy findings in strangulation. Our intention is for the results to be used in future death investigations, where difficulties in interpretation of findings in potential asphyxial deaths arise. Asphyxia homicides showed a strong bias with respect to sex, age, and homicide type. The frequent female victim was typically an adult, whereas the rarer male victim was most often a child. Female offenders most often killed their children, and male offenders most often killed their female partner. Generally, most asphyxia homicides took place in a domestic setting. Manual strangulation and ligature strangulation were the most common mechanisms of asphyxia homicides (81.6%). A lack of petechial hemorrhages, especially in the conjunctiva, was rare in homicidal strangulation, but there were exceptions, especially when there was postmortem decomposition, making it impossible to verify them. Most victims of strangulation had skin lesions in the face (including the jawline) or on the neck, with accompanying hemorrhages in muscle and connective tissue, but the findings could be subtle or compounded by decomposition. Fractures of the laryngo-hyoid complex were common in strangulation, particularly in manual strangulation (chi-sq = 4.0993, df = 1, P < 0.05) and were clearly related to the age of the victim (chi-sq = 82.193, df = 4, P < 0.001). In children and young adults dying from homicidal strangulation, a lack of fractures is to be expected, while a lack of fractures is unusual, but not entirely unexpected, for adults and aged people.

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References

  1. Shkrum MJ, Ramsay DA (2007) Forensic pathology of trauma: common problems for the pathologist. Forensic science and medicine. Forensic science and medicine. Totowa. Humana Press. xiii, N.J., p 646

    Book  Google Scholar 

  2. Sauvageau A, Boghossian E (2010) Classification of asphyxia: the need for standardization. J Forensic Sci 55(5):1259–1267

    Article  Google Scholar 

  3. Thomsen AH et al (2019) Homicide in Denmark 1992–2016. Forensic Sci Int: Synergy 1:275–282

  4. Rogde S, Hougen HP, Poulsen K (2001) Asphyxial homicide in two Scandinavian capitals. Am J Forensic Med Pathol 22(2):128–133

    CAS  Article  Google Scholar 

  5. Wahlsten P, Eriksson A (2020) Asphyxia homicides in Finland, 1983–2012. J Forensic Sci 65(5):1548–1556

    Article  Google Scholar 

  6. Harm T, Rajs J (1981) Types of injuries and interrelated conditions of victims and assailants in attempted and homicidal strangulation. Forensic Sci Int 18(2):101–123

    CAS  Article  Google Scholar 

  7. Rajs J, Thiblin I (2000) Histologic appearance of fractured thyroid cartilage and surrounding tissues. Forensic Sci Int 114(3):155–166

    CAS  Article  Google Scholar 

  8. Sauvageau A, Ambrosi C, Kelly S (2012) Autoerotic nonlethal filmed hangings: a case series and comments on the estimation of the time to irreversibility in hanging. Am J Forensic Med Pathol 33(2):159–162

    Article  Google Scholar 

  9. Camps FE, Hunk AC (1959) Pressure on the neck. J. Forensic Med 6:116–135

    Google Scholar 

  10. Pollanen MS (2001) Subtle fatal manual neck compression. Med Sci Law 41(2):135–140

    CAS  Article  Google Scholar 

  11. Pollanen MS (2005) Deciding the cause of death after autopsy–revisited. J Clin Forensic Med 12(3):113–121

    Article  Google Scholar 

  12. Pollanen MS (2012) Forensic pathology and the miscarriage of justice. Forensic Sci Med Pathol 8(3):285–289

    Article  Google Scholar 

  13. Ely SF, Hirsch CS (2000) Asphyxial deaths and petechiae: a review. J Forensic Sci 45(6):1274–1277

    CAS  Article  Google Scholar 

  14. Klysner A, Lynnerup N, Hougen HP (2011) Is acute alveolar dilation an indicator of strangulation homicide? Med Sci Law 51(2):102–105

    Article  Google Scholar 

  15. Fieguth A et al (2003) Fatal trauma to the neck: immunohistochemical study of local injuries. Forensic Sci Int 135(3):218–225

    Article  Google Scholar 

  16. Cordner S et al (2020) Suicidal ligature strangulation: a systematic review of the published literature. Forensic Sci Med Pathol 16(1):123–133

    Article  Google Scholar 

  17. Maxeiner H, Bockholdt B (2003) Homicidal and suicidal ligature strangulation–a comparison of the post-mortem findings. Forensic Sci Int 137:60–66

    CAS  Article  Google Scholar 

  18. Ganpat SM et al. (2011) Homicide in Finland, the Netherlands and Sweden: A first study on the European homicide monitor data

  19. Gennarelli TA, Wodzin E (2008) Abbreviated injury scale 2005, update 2008. Barrington, Ill.: Association for the Advancement of Automative Medicine

  20. Thomsen AH et al (2020) Sharp force homicide in Denmark 1992–2016. J Forensic Sci 65(3):833–839

    Article  Google Scholar 

  21. Thomsen AH et al (2020) Improved medical treatment could explain a decrease in homicides with a single stab wound. Forensic Sci Med Pathol 16(3):415–422

  22. DiMaio VJ (2000) Homicidal asphyxia. Am J Forensic Med Pathol 21(1):1–4

    CAS  Article  Google Scholar 

  23. Suffla S, Seedat M (2016) The epidemiology of homicidal strangulation in the City of Johannesburg South Africa. J Forensic Leg Med 37:97–107

    Article  Google Scholar 

  24. Thomsen AH et al (2021) Gunshot homicides in Denmark 1992–2016. Int J Legal Med, 135(4):1507–1514

  25. Rao VJ, Wetli CV (1988) The forensic significance of conjunctival petechiae. Am J Forensic Med Pathol 9(1):32–34

    CAS  Article  Google Scholar 

  26. Clement R et al (2011) Petechiae in hanging: a retrospective study of contributing variables. Am J Forensic Med Pathol 32(4):378–382

    Article  Google Scholar 

  27. Ikeda T et al (2019) Effects of postmortem positional changes on conjunctival petechiae. Forensic Sci Med Pathol 15(1):13–22

    Article  Google Scholar 

  28. Maxeiner H, Jekat R (2010) Resuscitation and conjunctival petechial hemorrhages. J Forensic Leg Med 17(2):87–91

    CAS  Article  Google Scholar 

  29. Plattner T, Bolliger S, Zollinger U (2005) Forensic assessment of survived strangulation. Forensic Sci Int 153(2–3):202–207

    CAS  Article  Google Scholar 

  30. Bedford PJ, Oesterhelweg L (2013) Different conditions and strategies to utilize forensic radiology in the cities of Melbourne, Australia and Berlin Germany. Forensic Sci Med Pathol 9(3):321–326

    Article  Google Scholar 

  31. Yen K et al (2005) Strangulation signs: initial correlation of MRI, MSCT, and forensic neck findings. J Magnet Reson Imaging 22(4):501–510

    Article  Google Scholar 

  32. Dunsby AM, Davison AM (2011) Causes of laryngeal cartilage and hyoid bone fractures found at postmortem. Med Sci Law 51(2):109–113

    Article  Google Scholar 

  33. Maxeiner H (1998) “Hidden” laryngeal injuries in homicidal strangulation: how to detect and interpret these findings. J Forensic Sci 43(4):784–791

    CAS  Article  Google Scholar 

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Funding

Asser Hedegård Thomsen has received funding from Brødrene Hartmanns Fond (A26707).

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Correspondence to Asser H. Thomsen.

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Thomsen, A.H., Leth, P.M., Hougen, H.P. et al. Asphyxia homicides in Denmark 1992–2016. Int J Legal Med (2022). https://doi.org/10.1007/s00414-022-02787-0

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  • DOI: https://doi.org/10.1007/s00414-022-02787-0

Keywords

  • Homicide
  • Asphyxia
  • Strangulation
  • Forensic autopsy
  • Interpersonal violence
  • Forensic medicine