Karbonmonoksit ile İlgili Ölümlerin Adli ve Epidemiyolojik Değerlendirilmesi: Türkiye’nin Güneyinden On Yıllık Otopsi Çalışmas

Abstract

Amaç: Karbonmonoksit (CO) zehirlenmesi, dünya genelinde önemli ve önlenebilir bir ölüm nedeni olmaya devam etmektedir. Bu çalışmanın amacı, Antalya, Türkiye’de otopsisi yapılan ölümcül CO zehirlenmesi vakalarının epidemiyolojik, toksikolojik ve adli özelliklerini değerlendirmektir. Gereç Ve Yöntem: 2011 ile 2020 yılları arasında Antalya’da gerçekleştirilen 8.649 otopsi arasında, CO zehirlenmesi tanısı konulan 105 olgu retrospektif olarak incelenmiştir. Olgulara ait yaş, cinsiyet, mevsimsel dağılım, olayın gerçekleştiği yer, COHb düzeyleri, otopsi bulguları ve toksikolojik analiz sonuçları değerlendirilmiştir. COHb düzeyleri, moleküler absorbsiyon spektrofotometrisi yöntemiyle ölçülmüştür. İstatistiksel analizlerde Mann–Whitney U, Fisher’s Exact ve Spearman korelasyon testleri kullanılmıştır. Bulgular: 105 olgunun 68’i (%64,8) erkek, 37’si (%35,2) kadındı. Ölümlerin çoğunluğu kış mevsiminde (%56,2) ve konut ortamında (%71,4) gerçekleşmiştir. Katı yakıtla çalışan sobalar, CO maruziyetinin en yaygın kaynağı olarak saptanmıştır (%30,5). Ortalama COHb düzeyi %56,5 olup, yaşlı bireylerde ve kronik hastalığı bulunanlarda anlamlı olarak daha düşük seviyeler tespit edilmiştir (p<0,05). Olguların %19,1’inde CO zehirlenmesine geniş yanıklar da eşlik etmiştir. COHb düzeyleri, yaş ile ters yönde korelasyon göstermiş; eşlik eden hastalığı veya termal yaralanması olan olgularda daha düşük bulunmuştur. Sonuç: Ölümcül CO zehirlenmesi, özellikle yetersiz havalandırılan ortamlarda kullanılan katı yakıtlı sobalarla ilişkili olarak hâlâ büyük ölçüde önlenebilir bir halk sağlığı sorunu olmaya devam etmektedir. Postmortem COHb tayini, tanı açısından en güvenilir yöntemdir. Kamu spotları, yapısal güvenlik önlemlerinin iyileştirilmesi ve multidisipliner iş birliği, CO’ya bağlı ölümlerin azaltılmasında temel unsurlardır.

Keywords

• Karbonmonoksit zehirlenmesi
• Karboksihemoglobin
• Adli otopsi
• Postmortem bulgular
• Toksikoloji
• Halk sağlığı

Forensic and Epidemiological Evaluation of Carbonmonoxide-Related Deaths: A Ten-Year Autopsy Study from Southern Turkiye

Abstract

Aim: Carbon monoxide (CO) poisoning remains a significant and preventable cause of accidental deaths worldwide. This study aims to evaluate the epidemiological, toxicological, and forensic characteristics of fatal CO poisoning cases that underwent autopsy in Turkiye. Methods: A retrospective review was conducted on 105 autopsy cases diagnosed with CO poisoning among 8,649 autopsies performed between 2011 and 2020 at the Antalya. Data regarding age, sex, seasonality, origin of the incident, COHb levels, autopsy findings, and toxicological results were analyzed. Results: Of the 105 cases, 68 (64.8%) were male and 37 (35.2%) were female. The majority of deaths occurred in winter (56.2%) and within residential settings (71.4%). Solid-fuel stoves were the most common source of CO exposure (30.5%). The mean COHb level was 56.5%, with significantly lower levels observed in elderly individuals and those with chronic illnesses (p<0.05). In 19.1% of cases, CO poisoning was accompanied by extensive burns. COHb levels correlated inversely with age and were lower in cases with comorbid conditions and thermal injury. Conclusion: Fatal CO poisoning remains a largely preventable public health concern, particularly associated with solid-fuel stoves in poorly ventilated environments. Postmortem COHb quantification remains the most reliable diagnostic tool. Public education, structural safety improvements, and multidisciplinary collaboration are essential to reduce CO-related fatalities.

Keywords

• Carbon monoxide poisoning
• Carboxyhemoglobin
• Forensic autopsy
• Postmortem findings
• Toxicology
• Public health

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