kjlm The Korean Journal of Laboratory Medicine Korean J Leg Med 2383-5702 2383-5710 The Korean Society for Legal Medicine 10.7580/kjlm.2014.38.4.145 kjlm-38-145 Original Article The Statistical Analysis on Legal Autopsy Performed in Korea during 2013 Year JangSeon Jung 1 ParkJong-Pil 2 ChoiByung Ha 2 ChungNak Eun 1 LeeHan Young 2 SeoJoong Seok 2 Division of Forensic Medicine Investigation, Seoul Institute, National Forensic Service, Seoul, Korea Medical Examiner's Office, National Forensic Service, Wonju, Korea Corresponding Author Seon Jung Jang Department of Forensic Investigation, Seoul Institute, National Forensic Service, 139 Jiyang-ro, Yangcheon-gu, Seoul 158-707, Korea TEL: +82-2-2600-4632 FAX: +82-2-2600-4828 E-mail: jsj9600@korea.kr 02 2014 04 02 2014 38 4 145 154 11102014 11112014 19112014 Copyright © 2014 The Korean Society for Legal Medicine 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Medicolegal autopsy is a vital tool for obtaining reliable injury mortality data. This study statistically analyzed data obtained from medicolegal autopsies performed in Korea in 2013. The aim of this study was to analyze various aspects of the 4,861 deaths that were categorized as unusual in Korea in 2013. A total of 4,861 deaths were analyzed by gender, age, manner of death, and cause of death. Of the 4,861 deaths, 3,542 (73.3%) were of men and 1,302 (26.7%) were of women. With respect to the manner of death, 54.4% were recorded as unnatural deaths, 38.8% were natural deaths, and 6.9% had unknown causes. Of the 2,642 unnatural deaths, 45.0% were determined to be accidental deaths, 26.3% suicidal, 16.9% homicidal, and 11.8% undetermined. Of the total number of unnatural deaths, 42.1% were trauma-related deaths, for which falling down accounted for 33.8%. Asphyxiation accounted for 16.0% of unnatural deaths, and of these, the predominant cause was hanging (58.8%). In addition, 14.4% of deaths were due to drowning, 12.9% poisoning, 11.0% thermal injuries, 1.8% complications arising from medical procedures, and 0.8% electrocution, starvation, or neglect. Among the 1,886 natural deaths, heart diseases accounted for 52.0% and vascular diseases accounted for 16.9%. Of the 196 deaths among children under the age of 10 years, 41.8% were recorded as unnatural deaths, 45.1% were natural deaths, and 1.5% had unknown causes.

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Deaths, Unnatural Deaths, and Autopsies in Korea during 2013

Variable Deaths Unnatural Autopsies Autopsy rate (%)
1 2
Seoul 42,063 5,671 1,104 2.6 19.5
Busan 20,096 1,848 281 1.4 15.2
Incheon 13,039 1,731 408 3.1 23.6
Daegu 12,531 1,552 –* NA NA
Gwangju 6,891 955 102 1.5 10.7
Daejeon 6,634 972 83 1.3 8.5
Ulsan 4,871 698 –* NA NA
Sejong 812 –* –* NA NA
Gyeonggi 50,959 7,788 1,354 2.7 17.4
Gangwon 10,756 1,691 196 1.8 11.6
Chungbuk 10,371 1,614 169 1.6 10.5
Chungnam 13,854 2,427 291 2.1 12.0
Jeonbuk 13,492 2,893 155 1.1 5.4
Jeonnam 16,332 2,765 245 1.5 8.9
Gyeongbuk 20,245 1,881 242 1.2 12.9
Gyeongnam 19,994 2,177 231 1.2 10.6
Jeju 3,317 652 –* NA NA
Total 266,257 37,315 4,861 1.8 13.0

Autopsy rate 1, autopsies/deaths; Autopsy rate 2, autopsies/ unnatural deaths; NA, not analyzed.*Autopsy data has not been fully collected.

Age, Sex, and Manner of Death of Total Number of Legal Autopsies Performed in Korea during 2013

Age (yr) Sex Manner of death Total
Unnatural Suicide Homicide Accident U Undetermine d Natural Unknown Subtotal
≤9 M 51 0 29 20 2 63 3 117 ,196 (4.0)
  F 31 0 12 17 2 48 0 79  
10–19 M 45 9 11 20 5 15 4 64 ,095 (2.0)
  F 21 3 9 7 2 7 3 31  
20–29 M 142 42 15 64 21 58 17 217 ,313 (6.4)
  F 75 37 14 18 6 16 5 96  
30–39 M 275 82 28 138 27 183 28 486 0,692 (14.2)
  F 135 70 27 29 9 65 6 206  
40–49 M 402 100 54 199 49 390 48 840 1,122 (23.1)
  F 174 64 41 49 20 97 11 282  
50–59 M 494 106 71 263 54 464 62 1,020 1,272 (26.2)
  F 144 32 46 47 19 94 14 252  
60–69 M 206 41 26 113 26 211 29 446 0,593 (12.2)
  F 101 28 21 46 6 39 7 147  
70–79 M 122 26 11 68 17 56 11 189 ,303 (6.2)
  F 74 13 18 37 6 35 5 114  
≥80 M 25 3 5 16 1 20 3 48 ,117 (2.4)
  F 49 11 9 24 5 16 4 69  
NI M 55 23 0 8 24 8 52 115 ,158 (3.3)
  F 16 1 0 6 9 1 9 26  
  NI 5 3 0 0 2 0 12 17  
Subtotal M 1,817 432 250 909 226 1,468 257 3,542 4,861 (100).
  F 820 259 197 280 84 418 64 1,302  
Total   2,642 (54.4) 694 (26.3) 447 (16.9) 1,189 (45.0) 312 (11.8) 1,886 (38.8) 333 (6.9) 4,861 (100)  

Values are presented as number (%). M, male; F, female; NI, not identified.

Cause of Death and Sex in Unnatural Death of Legal Autopsies Performed in Korea during 2013

Variable Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Trauma 82 31 0 202 126 0 478 94 0 77 22 0 839 273 0 1,112 (42.1)
Asphyxia 155 108 2 28 60 0 50 14 0 1 4 0 234 186 2 1,422 (16.0)
Drowning 44 31 0 2 3 0 101 27 0 130 41 2 277 102 2 1,381 (14.4)
Poisoning 125 79 1 4 4 0 80 37 0 5 7 0 214 127 1 1,342 (12.9)
Thermal injury 25 9 0 6 3 0 160 66 0 12 10 0 203 88 0 1,291 (11.0)
Electrocution 1 0 0 0 0 0 16 2 0 1 0 0 18 2 0 1,20 (0.8)
Starvation/ 0 0 0 6 2 0 7 5 0 0 0 0 13 7 0 1,20 (0.8)
neglect                                
Medical 0 0 0 0 0 0 14 34 0 0 0 0 14 34 0 1,48 (1.8)
procedure                                
Anaphylaxis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Unknown 0 0 0 1 0 0 1 0 0 0 0 0 2 0 0 1,02 (0.1)
Others 0 1 0 0 0 0 3 0 0 0 0 0 3 1 0 1,04 (0.2)
Subtotal 432 259 3 249 198 0 910 279 0 226 84 2 1,817 820 5 2,642
  (16.4) (9.8) (0.1) (9.4) (7.5)   (34.4) (10.6)   (8.6) (3.2) (0.1) (68.8) ( (31.0) (0.2) (100)
Total 694 (26.3) 447 (16.9) 1,189 (45.0) 312 (11.8)   –   –

Values are presented as number (%). M, male; F, female; NI, not identified.

Cause of Death in Trauma of Legal Autopsies Performed in Korea during 2013

Variable Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Blunt force injury 01 01 0 095 061 0 72 8 0 41 11 0 209 081 0 1,290 (26.1)
Sharp force injury 25 07 0 088 063 0 004 1 0 03 01 0 120 072 0 1,192 (17.3)
Gunshot injury 06 00 0 006 001 0 000 0 0 00 00 0 012 001 0 1,13 (1.2)
Traffic injury 03 01 0 000 001 0 176 51 0 01 00 0 180 053 0 1,233 (21.0)
Fall down 47 22 0 013 000 0 219 33 0 32 10 0 311 065 0 1,376 (33.8)
Explosion 00 00 0 000 000 0 007 1 0 0 00 0 007 001 0 1,08 (0.7)
Others 00 00 0 000 000 0 000 0 0 0 00 0 000 000 0 00
Subtotal 82 31 0 202 126 0 478 94 0 77 22 0 839 273 0 1,112 (100),
  (7.4) (2.8)   (18.2) (11.3)   (43.0) (8.5)   (6.9) (2.0)   (75.4) (24.6)    
Total 113 (10.2) 328 (29.5) 572 (51.4) 9 99 (8.9)   1,112 (100) –

Values are presented as number (%). M, male; F, female; NI, not identified.

Fatal Sites of Blunt Force Injury and Manner of Death of Legal Autopsies Performed in Korea during 2013

Variable Head Neck Chest Abdomen Extremity Multiple TSH PSH Total
Suicide 2 1 0 0 0 0 0 0 03 (1.0)
Homicide 89 2 0 16 0 28 14 2 151 (52.1)
Accident 32 2 7 8 0 30 0 1 080 (27.6)
Undetermined 36 1 4 3 0 12 0 0 056 (19.3)
Total 159 (54.8) 6 (2.1) 11 (3.8) 27 (9.3) 0 70 (24.1) 14 (4.8) 3 (1.0) 290 (100).

Values are presented as number (%). TSH, traumatic shock; PSH, primary shock.

Fatal Sites of Sharp Force Injury and Manner of Death of Legal Autopsies Performed in Korea during 2013 Year

Variable Head Neck Chest Abdomen Back Arm Leg Multiple Total
Suicide 0 10 10 06 0 6 0 00 032 (16.7)
Homicide 1 24 44 22 3 4 5 48 151 (78.6)
Accident 0 02 01 00 0 0 2 00 05 (2.6)
Undetermined 0 01 00 00 0 1 1 01 04 (2.1)
Total 1 (0.5) 37 (19.3) 55 (28.6) 28 (14.6) 3 (1.6) 11 (5.7) 8 (4.2) 49 (25.5) 192 (100).

Values are presented as number (%).

Cause of Death in Asphyxia of Legal Autopsies Performed in Korea during 2013 Year

Variable Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Hanging 144 102 2 00 00 0 00 00 0 0 0 0 144 102 2 248 (58.8)
Ligature strangulation 002 004 0 13 15 0 01 02 0 1 2 0 017 023 0 40 (9.5)
Manual strangulation 000 000 0 10 31 0 00 00 0 0 0 0 010 031 0 41 (9.7)
Chocking 001 000 0 00 01 0 17 08 0 0 0 0 018 009 0 27 (6.4)
Smothering 007 002 0 04 07 0 03 01 0 0 0 0 014 010 0 24 (5.7)
Crushing asphyxia 000 000 0 00 00 0 05 02 0 0 0 0 005 002 0 07 (1.7)
Postural asphyxia 001 000 0 00 00 0 06 01 0 0 0 0 007 001 0 08 (1.9)
Oxygen deficiency 000 000 0 00 00 0 17 00 0 0 0 0 017 000 0 17 (4.0)
Combined 000 000 0 01 06 0 01 00 0 0 2 0 002 008 0 10 (2.4)
Subtotal 155 108 2 28 60 0 50 14 0 1 4 0 234 186 2 422 (100).
  (36.7) (25.6) (0.5) (6.6) (14.2)   (11.8) (3.3)   (0.2) (0.9)   (55.5) (44.1) (0.5)  
Total 265 (62.8) 88 (20.9) 64 (15.2)   5 (1.2)   422 (100) –

Values are presented as number (%). M, male; F, female; NI, not identified.

Cause of Death in Poisoning of Legal Autopsies Performed in Korea during 2013

Variable Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Ethanol 000 01 0 0 0 0 31 16 0 0 0 0 031 017 0 48 (14.0)
Carbon monoxide 045 18 0 2 3 0 17 07 0 1 2 0 065 030 0 95 (27.8)
Cyanides 010 00 0 0 0 0 01 00 0 1 0 0 012 000 0 12 (3.5)0
Agrochemicals 032 21 0 2 1 0 04 00 0 1 2 0 039 024 0 63 (18.4)
Narcotics 000 00 0 0 0 0 03 02 0 0 0 0 003 002 0 5 (1.5)
Therapeutic drugs 029 33 0 0 0 0 14 10 0 2 3 0 045 046 0 91 (26.6)
Organic solvents 004 03 0 0 0 0 03 00 0 0 0 0 007 003 0 10 (2.9)0
Combined 002 01 1 0 0 0 01 00 0 0 0 0 003 001 1 5 (1.5)
Others 003 02 0 0 0 0 06 02 0 0 0 0 009 004 0 13 (3.8)0
Subtotal 125 79 1 4 4 0 80 37 0 5 7 0 214 127 1 342 (100)0
  (36.5) (23.1) (0.3) (1.2) (1.2)   (23.4) (10.8)   (1.5) (2.0)   (62.6) (37.1) (0.3)  
Total 205 (59.9)   8 (2.3)   117 (34.2) 12 (3.5) 342 (100) –

Values are presented as number (%). M, male; F, female; NI, not identified.

Cause of Death in Thermal Injury of Legal Autopsies Performed in Korea during 2013

Variable Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Fire 24 7 0 2 3 0 118 50 0 12 08 0 156 68 0 224 (77.0)
Burn 01 2 0 4 0 0 007 02 0 00 02 0 012 06 0 18 (6.2)
Heat stroke 00 0 0 0 0 0 002 01 0 00 00 0 002 01 0 03 (1.0)
Hypothermia 00 0 0 0 0 0 033 13 0 00 00 0 033 13 0 046 (15.8)
Subtotal 25 9 0 6 3 0 160 66 0 12 10 0 203 88 0 291 (100).
  (8.6) (3.1)   (2.1) (1.0)   (55.0) (22.7)   (4.1) (3.4)   (69.8) (30.2)    
Total 34 (11.7)   9 (3.1)   226 (77.7) 22 (7.6) 291 (100) –

Values are presented as number (%). M, male; F, female; NI, not identified.

Cause of Death and Sex in Natural Death of Legal Autopsies Performed in Korea during 2013

Variable Cause of death Male Female NI Subtotal Total
Heart Ischemic disease 0,613 074 0 687 (70.0) 981 (52.0)
  Myocardial disease 0,025 009 0 034 (3.5)  
  Valvular disease 0,002 000 0 002 (0.2)  
  Others 0,215 043 0 258 (26.3)  
Vascular system Cerebral vessel 0,131 085 0 216 (67.9) 318 (16.9)
  Aorta 0,032 016 0 048 (15.1)  
  Pulmonary vessel 0,008 008 0 016 (5.0)  
  Esophageal varix 0,034 004 0 038 (11.9)  
  Others 0,000 000 0 000  
Respiratory system Larynx/pharynx 0,002 000 0 002 (3.5) 57 (3.0)
  Trachea 0,000 000 0 000  
  Lung 0,041 013 0 054 (94.7)  
  Others 0,001 000 0 001 (1.8)  
Digestive tract Stomach/intestine 0,027 002 0 029 (32.2) 90 (4.8)
  Liver 0,033 019 0 052 (57.8)  
  Pancreas 0,005 002 0 007 (7.8)  
  Others 0,002 000 0 002 (2.2)  
Endocrine/nutritional Chronic alcoholism 0,101 042 0 143 (85.6) 167 (8.9)0
/metabolic disorder Diabetes 0,011 007 0 018 (10.8)  
  Others 0,005 001 0 006 (3.6)  
Pregnancy/puerperium/delivery Hemorrhage 0,000 007 0 007 (46.7) 15 (0.8)
  Embolism 0,000 005 0 005 (33.3)  
  Hypertensive disorder 0,000 000 0 000  
  Others 0,000 003 0 003 (20.0)  
Perinatal conditions Hypoxia 0,008 004 0 012 (50.0) 24 (1.3)
  Others 0,004 008 0 012 (50.0)  
Miscellaneous   0,069 028 0 097 97 (5.1)
Ill-defined mortality SMDS 0,038 002 0 040 137 (7.3)0
  SIDS 0,024 022 0 046  
  Unknown 0,038 013 0 051  
Total   1,469 417 0   1,886 (100)0.,

Values are presented as number (%). NI, not identified; SMDS, sudden manhood death syndrome; SIDS, sudden infant death syndrome.

Cause of Death and Sex in Miscellaneous Natural Death of Legal Autopsies Performed in Korea during 2013

Variable Cause of death Male Female Subtotal Total
Central nervous system Epilepsy 11 3 14 (73.7) 19
  Encephalomeningitis 03 1 04 (21.1)  
  Others 01 0 01 (5.3)  
Certain infection Septisemia 15 3 18 (69.2) 26
  Tuberculosis 04 1 05 (19.2)  
  Others 01 2 03 (11.5)  
Neoplasm Respiratory 04 0 04 (14.8) 27
  Central nervous system 01 3 04 (14.8)  
  Digestive 05 0 05 (18.5)  
  Others 06 8 14 (51.9)  
Genitourinary disease Kidney 02 1 03 (33.3) 09
  Others 02 4 06 (66.7)  
Congenital disease Heart 03 2 05 (100) 05
  Others 00 0 00  
Others   11 0 11 (100) 11

Values are presented as number (%).

Manner of Death in Children under 10 Years of Legal Autopsies Performed in Korea during 2013

Variable Neonate* Infancy� Preschool� Prepuberty§ Subtotal Total
M F M F M F M F M F
Unnatural 14 04 11 12 16 08 10 07 051 31 82 (41.8)
Suicide 00 00 00 00 00 00 00 00 000 00 00000
Homicide 12 02 06 03 06 05 05 02 029 12 41 (50.0)
Accident 02 02 04 07 09 03 05 05 020 17 37 (45.1)
Undetermined 00 00 01 02 01 00 00 00 002 02 4 (4.9)
Natural 19 16 34 27 08 02 02 03 063 48 111 (56.6)0
Unknown 01 00 01 00 00 00 01 00 003 00 03 (1.5)0
Subtotal 34 20 46 39 24 10 13 10 117 79 196 (100)0.
  (17.3) (10.2) (23.5) (19.9) (12.2) (5.1) (6.6) (5.1) (59.7) (40.3)  
Total 54 (27.6) 85 (43.4) 34 (17.3) 23 (11.7) 196 (100) –

Values are presented as number (%). M, male; F, female.*Neonate, birth-4 weeks;

Infancy, 1 month-1 year;

Preschool, 2–5 years;

Prepubertal, 6–9 years.

Analysis of Unknown Cause of Death Cases Performed in Korea during 2013

Manner of death Case of unknown cause of death Total
Putrified Skeletonized Infancy Others
Unnatural 003 00 01 03 007 (1.8)
Suicide 000 00 00 00 000
Homicide 000 00 01 00 001 (14.3)
Accident 003 00 00 02 005 (71.4)
Undetermined 000 00 00 01 001 (14.3)
Natural 010 00 15 26 051 (13.0)
Unknown 198 47 02 86 333 (85.2)
Subtotal 211 (54.7) 47 (12.2) 18 (4.7) 115 (29.8) 391 (100)

Values are presented as number (%).