Increased Adrenaline to Noradrenaline Ratio is a Superior Indicator of Antemortem Hypothermia Compared With Separate Catecholamine Concentrations

• NCJ Number: 236193
• Journal: Journal of Forensic Sciences Volume: 56 Issue: 5 Dated: September 2011 Pages: 1213-1218
• Author(s): Lasse Pakanen, B.M.; Marja-Leena Kortelainen, M.D., Ph.D.; Terttu Sarkioja, M.D., Ph.D.; Katja Porvari, Ph.D.
• Date Published: September 2011
• Length: 6 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

The significance of urinary catecholamines and small gastric mucosal bleedings, Wischnewsky's spots, in postmortem diagnosis of hypothermia deaths was evaluated.

Abstract

Autopsy cases (n = 358) were divided into hypothermia, suspected hypothermia, and control groups. The catecholamine levels did not correlate with the length of the postmortem period. The adrenaline to noradrenaline ratio was most effective in detecting hypothermia (68.9 percent sensitivity, 78.1 percent specificity). The median adrenaline concentrations were significantly higher in hypothermia than in control groups. The control group containing mostly sudden cardiac deaths with no cold exposure had a noradrenaline level comparable to the hypothermia groups. The sensitivity and specificity of determining Wischnewsky's spots in hypothermia deaths were 63.9 percent and 88.3 percent, respectively. The adrenaline to noradrenaline ratio is more suitable in proving antemortem cold stress than either of these independently, and its diagnostic value is comparable to that of Wischnewsky's spots. (Published Abstract)