Medicolegal autopsies in North Central Nigeria.

OBJECTIVE To determine the pattern and the causes of deaths reported to the coroner for medicolegal autopsies in North Central Nigeria. DESIGN A descriptive retrospective study. SETTING Jos University Teaching Hospital, Jos, Nigeria between January 1996 to December 2003. SUBJECTS Autopsies reports of 279 subjects whose causes of death were subjects of litigation. MAIN OUTCOME MEASURES The causes of death in medicolegal autopsies. RESULTS A total of 279 cases of medicolegal autopsies with identified causes of death were recorded representing 89% of all the autopsy examinations performed within the period. In 7.6% of cases, there was no identifiable cause of death. There were 127 males against 52 females with a male: female ratio of 4.5:1 and their ages ranged between two and 74 years with a mean of 34.7+/-8.2 years. Children aged < 15 years made up 29% of the cases and were distributed as follows: 4% of the children were aged 0-5 years, 9% between six to ten years while 17% were between 11 - 15 years. Accidental deaths made up 51% of the cases, homicides 36% and sudden deaths 13%. Road traffic accidents were responsible for 76% of all accidental deaths. Children were affected in 34% of the accidental deaths and half of them were pedestrians at the time of accident. The male: female ratio of deaths from road traffic accidents was 3:1 with mean age of 24 years. In all the accidental deaths, abdominal injuries were responsible for 47% while 30% died from chest injuries. Of the homicide cases male subjects outnumbered female in a ratio of 16:1 and children were affected in 28% of homicides. Injuries sustained during ethnic and religious crisis were responsible for 48% of the deaths from homicide and 15% of them were children. Armed robbery was responsible for 28% cases while physical assaults were responsible for 20% of homicides. Chest injuries were the causes of death in 54% and abdominal injuries in 36% of homicides. Cardiovascular deaths were responsible for 63% cases of all sudden natural deaths referred for Coroner's inquest during the period. Children made up 11% of all sudden natural deaths. Males outnumbered females in cardiovascular deaths in a ratio of 6:1 and 46% cases of them died of hypertensive heart failure, 32% had cerebrovascular accidents, pulmonary embolism in 13.6% and myocardial infarction in 9%. One case of myocardial infarction died during intercourse. CONCLUSION Road traffic accidents, violent communal unrest and armed robbery were responsible for 66% of the medicolegal autopsies in our environment. Public enlightenment, good road maintenance and safe driving culture as well as sustainable security for life and property would reduce the incidence of preventable deaths.