Kesici alet yaralanmalarına bağlı ölümlerde orijin tespiti parametrelerinin değerlendirilmesi

Öz

AMAÇ: Özellikle çoklu veya atipik yerleşimli kesici alet yaralanmalarının orijin tespitinde adli süreçler açısından zorluklar yaşanmaktadır. Bu nedenle, kesici alet yaralanmalarının orijin tespitinde dikkate alınan parametreleri ayrıntılı şekilde incelemek amaçlanmıştır. YÖNTEM: Çalışmanın örneklem grubuna, 01.01.2008 - 31.12.2012 tarihleri arasında mevcut yaralanmanın kişinin kendisi tarafından meydana getirilip getirilmediği sorusu ile merkezimize gönderilen kesici alet yaralanmasına bağlı ölüm olguları dahil edildi. Olgular, demografik-olay yeri-tıbbi kayıtlar, kesici alet özelliği, yara lokalizasyonu, yara tarifi, tereddüt-savunma-kemik kesilerinin varlığı-yerleri ve toksikolojik inceleme parametreleri çerçevesinde incelenerek tanımlayıcı istatistik karşılaştırmalar üzerinden tartışıldı. BULGULAR: Tanımlanan özellikleri taşıyan 35 olgu tespit edildi. Olguların 25’inde ölüme neden olan kesici alet yaralanmasının kişinin kendisi tarafından oluşturabileceği, ikisinde oluşturamayacağı, sekizinde ise ayırım yapılamadığı belirlendi. Yaralanmanın kişinin kendisi tarafından oluşturulabileceği yönünde karar verilen olgularda grup 1 erkek/kadın oranının 2: 1 ve yaş ortalamasının 44,04±18,39 olduğu, psikiyatrik patoloji %48 ve olay yerinde intihar notu varlığı %36 oranlarının daha yüksek olması önemli bulundu. Yaralanmasının kişinin kendisi tarafından oluşturulamayacağı yönünde karar verilen olgularda grup 2 ise olayın evde meydana gelme %100 , kullanılan aletin bıçak olma %100 , savunma kesisi bulunma %50 oranları ve tüm kesi türlerinin kemik doku dahil daha yüksek oranları dikkat çekici bulundu. SONUÇ: Ölenin erkek ve ileri yaşlarda olduğu, psikiyatrik patoloji, intihar notu, tereddüt kesilerinin varlığını ve savunma kesilerinin bulunmayışını içeren kesici alet yaralanmasına bağlı ölüm olaylarında, orijin yüksek ihtimalle intihar yönünde değerlendirilebilmektedir.

Anahtar Kelimeler

• Kesici alet yaralanması
• intihar notu
• tereddüt kesisi
• savunma kesisi
• orijin

Evaluation of manner of death determination parameters in deaths related to sharp force injury

Öz

OBJECTIVE: Detailed evaluation on the parameters considered in the manner of death determination of sharp force injuries is aimed in this study.METHODS: Death cases due to sharp force injuries that had been referred to our center between January 1, 2008 – December 31, 2012, with the questions whether the injury had been generated by the individual itself or not, were included in the sample group of the study. Cases were evaluated through the parameters of demographic-incident scene-medical records, features of the sharp object, localization-description of the wound, presence-localization of tentative-defense-bone cuts, toxicological analysis; and discussed through descriptive statistical comparisons.RESULTS: Thirty-five cases were included to the study. Of these cases, injury was determined as to be able to self inflicted in 25 cases while it was not in two, in 8 cases could not be determines either it was self inflicted or not. Male to female ratio of 2: 1, mean age of 44.04±18.39, and higher ratios of the presence of psychiatric pathology 48% and presence of a suicide note 36% were found to be important in cases reported in the direction of the fact that injury had been able to be generated by the individual itself grup 1 . Higher ratios of occurrence of the incident at home 100% , knife being the sharp object used %100 , presence of defense cuts 50% and all types of cuts including bone tissue were remarkable in cases reported in the direction of the fact that injury had not been able to be generated by the individual itself.CONCLUSION: Manner of death can be able to be estimated most likely in the direction of suicide when the incidents of sharp force injury related death involve an old aged male victim, presence of psychiatric pathology, suicide note, tentative cuts and absence of defense cuts.

Anahtar Kelimeler

• Sharp force injury
• suicide note
• tentative cut
• defense cut
• manner of death

Kaynakça

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