kjlm The Korean Journal of Laboratory Medicine Korean J Leg Med 2383-5702 2383-5710 The Korean Society for Legal Medicine 10.7580/kjlm.2015.39.4.99 kjlm-39-99 원 저 A Statistical Analysis of Legal Autopsies Performed in Korea in 2014 JangJung Sik 1 JangSeon Jung 2 ChoiByung Ha 1 LeeHan Young 2 ChungNak Eun 1 SeoJoong Seok 3 Medical Examiner’ s Office, National Forensic Service, Wonju, Korea Division of Forensic Medicine Investigation, National Forensic Service Seoul Institute, Seoul, Korea National Forensic Service, Wonju, Korea Correspondence to Sik Jung Jang Division of Forensic Investigation, National Forensic Service Seoul Institute, 139 Jiyang-ro, Yangcheon-gu, Seoul 08306, Korea Tel: +82-2-2600-4616 Fax: +82-2-2600-4744 E-mail: drjangjungsik@gmail.com 12015 1712015 394 99108 27102015 15112015 24112015 Copyright © 2015 The Korean Society for Legal Medicine 2015 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 autopsies are a vital tool for obtaining reliable injury mortality data. This study statistically analyzed the data obtained from medicolegal autopsies performed in Korea in 2014. A total of 5,324 deaths were analyzed by sex, age, manner of death, and cause of death. With respect to the manner of death, 56.3% were recorded as unnatural deaths, 38.4% were natural deaths, and 5.3% had unknown causes. Of the 2,998 unnatural deaths, 41.0% were determined to be accidental deaths; 28.1%, suicidal; 16.1%, homicidal; and 14.8%, undetermined. Of the total number of unnatural deaths, 38.8% were trauma-related, wherein falls accounted for 32.7%. Asphyxiation accounted for 16.3% of unnatural deaths; of these, the predominant cause was hanging (59.4%). In addition, 15.0% of the unnatural deaths were due to drowning; 14.8%, poisoning; 11.3%, thermal injuries; 2.5%, complications arising from medical procedures; and 0.4%, electrocution, starvation, or neglect. Among the 2,042 natural deaths, heart diseases accounted for 49.0% and vascular diseases accounted for 17.3%. Of the 170 deaths among children under the age of 10, 38.8% were recorded as unnatural deaths, 54.1% were natural deaths, and 7.1% had unknown causes.

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Deaths, unnatural deaths, and autopsies in Korea in 2014

  Deaths Unusual death Autopsies Autopsy rate (%)
1 2
Seoul 42,153 5,172 1,0090, 2.4 19.5
Busan 20,230 1,743 253 1.3 14.5
Incheon 13,409 1,695 409 3.1 24.1
Daegua) 12,642 1,658 0,94a) 0.7a) 5.7a)
Gwangju 6,935 940 119 1.7 12.7
Daejeon 6,564 974 142 2.2 14.6
Ulsana) 4,695 609 000,4a)0 0.1a) 0.7a)
Gyeonggi 51,425 7,268 1,4860, 2.9 20.4
Gangwon 11,004 1,641 206 1.9 12.6
Chungbuk 10,174 1,536 205 2.0 13.3
Chungnamb) 15,002 2,347 281 1.9 12.0
Jeonbuk 13,563 1,835 207 1.5 11.3
Jeonnam 16,053 2,126 324 2.0 15.2
Gyeongbuk 20,304 2,730 203 1.5 11.1
Gyeongnam 20,239 2,596 277 1.4 10.7
Jejua) 3,300 608 000,5a)0 0.2a) 0.8a)
Total 1 247,055 32,603 5,2210, 2.1 16.0
Total 2 267,692 35,478 5,3240, 2.0 15.0

Autopsy rate 1, autopsies/deaths; Autopsy rate 2, autopsies/unusual deaths; Total 1 except Daegu, Ulsan, and Jeju; Total 2 include Daegu, Ulsan, and Jeju.

Autopsy data has not been fully collected;

Chungnam includes Sejong.

Age, sex, and manner of death of total number of legal autopsies performed in Korea in 2014

Age (yr) Sex Manner of death Total
Unnatural Suicide Homicide Accident U Undetermined Natural Unknown Subtotal
≤9 M 34 0 18 13 3 47 9 90 196 (3.2)
F 32 0 24 7 1 45 3 80  
10-19 M 38 11 11 9 7 9 3 50 99 (2.0)
F 42 12 14 12 4 7 0 49  
20-29 M 133 48 19 48 18 71 4 208 300 (5.6)
F 65 27 18 13 7 22 5 92  
30-39 M 263 74 27 117 45 184 17 464 678 (12.7)
F 151 68 31 37 15 51 12 214  
40-49 M 448 125 54 190 78 432 45 925 1 1,243 (23.3)
F 199 81 44 54 20 104 15 318  
50-59 M 574 150 67 288 69 527 54 1,155 1 1,442 (27.1)
F 169 52 37 62 18 98 20 287  
60-69 M 262 61 27 132 42 202 21 485 653 (12.3)
F 94 24 27 35 8 66 8 168  
70-79 M 122 43 14 77 24 69 13 240 406 (7.6)
F 74 18 25 48 18 48 9 166  
≥80 M 44 9 6 25 4 20 3 67 171 (3.2)
F 73 10 15 38 10 28 3 104  
NI M 56 16 2 14 24 11 10 77 162 (3.0)
F 19 3 2 5 9 1 2 22  
NI 35 11 1 4 19 0 28 63  
Subtotal M 2,010 537 246 913 314 1,572 179 3,761 5 5,324 (100)
F 953 295 237 311 110 470 77 1,500  
NI 35 11 1 4 19 0 28 63  
Total   2,998 (56.3) 843 (28.1) 484 (16.1) 1,228 (41.0) ) 443 (14.8) 2 ,042 (38.4) 284 (5.3) 5,324 (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 in 2014

Cause of death Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Trauma 77 46 0 196 135 1 485 108 0 86 31 0 844 320 1 1,165 (38.8)
Asphyxia 178 125 10 28 78 0 51 14 1 2 1 0 259 218 11 488 (16.3)
Drowning 63 28 0 2 2 0 102 25 1 171 39 17 338 94 18 450 (15.0)
Poisoning 182 88 1 6 5 0 78 52 0 16 15 0 282 160 1 443 (14.8)
Thermal injury 35 6 0 8 9 0 144 73 2 39 20 2 226 108 4 338 (11.3)
Electrocution 0 0 0 0 0 0 6 1 0 0 0 0 6 1 0 7 (0.2)
Starvation/neglect 0 0 0 2 3 0 0 0 0 0 0 0 2 3 0 5 (0.2)
Medical procedure 0 0 0 0 0 0 38 37 0 0 1 0 38 38 0 76 (2.5)
Anaphylaxis 0 0 0 0 0 0 2 0 0 0 0 0 2 0 0 2 (0.1)
Unknown 1 0 0 0 3 0 0 1 0 0 0 0 1 4 0 5 (0.2)
Others 1 2 0 3 2 1 7 0 0 0 3 0 12 7 0 19 (0.6)
Subtotal 537 295 11 245 237 2 913 311 4 314 110 19 2,010 953 35  
  (17.9) (9.8) (0.4) (8.2) (7.9) (0.1) (30.4) (10.4) (0.1) (10.5) (3.7) (0.6) (67.0) (31.8) (1.2) 2,998 (100)
Total 843 (28.1) 484 (16.2) 1,228 (40.9) 443 (14.8) 2,998 (100) -

Values are presented as number (%).

M, male; F, female; NI, not identified.

Cause of death in trauma of legal autopsies performed in Korea in 2014

Cause of death Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Blunt force injury 0 1 0 93 69 0 59 8 0 44 13 0 196 91 0 287 (24.6)
Sharp force injury 36 10 0 89 61 1 5 2 0 7 1 0 137 74 1 212 (18.2)
Gunshot injury 1 0 0 0 2 0 2 0 0 0 0 0 3 2 0 5 (0.4)
Traffic injury 1 1 0 1 2 0 200 66 0 4 1 0 206 70 0 276 (23.7)
Fall down 39 34 0 13 1 0 214 32 0 31 16 0 297 83 0 380 (32.7)
Explosion 0 0 0 0 0 0 5 0 0 0 0 0 5 0 0 5 (0.4)
Others 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 (0)
Subtotal 77 46 0 196 135 1 485 108 0 86 31 0 844 320 1  
  (6.6) (4.0) (0) (16.8) (11.6) (0.1) (41.6) (9.3) (0) (7.3) (2.7) (0) (72.4) (27.5) (0.1) 1,165 (100)
Total 123 (10.6) 332 (28.5) 593 (50.9) 117 (10.0) 1,165 (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 in 2014

Cause of death Head Neck Chest Abdomen Extremity Multiple TSH PSH Total
Suicide 1 0 0 0 0 0 0 0 1 (0.3)
Homicide 98 0 6 12 0 33 11 0 160 (55.8)
Accident 29 4 6 3 2 22 1 2 69 (24.0)
Undetermined 38 3 2 9 0 5 0 0 57 (19.9)
Total 166 (57.8) 7 (2.4) 14 (4.9) 24 (8.4) 2 (0.7) 60 (20.9) 12 (4.2) 2 (0.7) 287 (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 in 2014

Cause of death Head Neck Chest Abdomen Back Arm Leg Multiple Total
Suicide 0 17 11 9 0 4 0 5 46 (21.7)
Homicide 3 25 42 22 2 2 3 52 151 (71.2)
Accident 0 1 2 2 1 1 0 0 7 (3.3)
Undetermined 0 1 0 4 0 1 0 2 8 (3.8)
Total 3 (1.4) 44 (20.8) 55 (25.9) 37 (17.5) 3 (1.4) 8 (3.8) 3 (1.4) 59 (27.8) 212 (100)

Values are presented as number (%).

Cause of death in asphyxia of legal autopsies performed in Korea in 2014

Cause of death Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Hanging 163 116 10 0 0 0 0 0 1 0 0 0 163 116 11 290 (59.4)
Ligature strangulation 7 8 0 7 19 0 0 2 0 0 0 0 14 29 0 43 (8.8)
Manual strangulation 0 0 0 13 42 0 0 0 0 0 0 0 13 42 0 55 (11.3)
Chocking 0 0 0 0 1 0 20 10 0 0 0 0 20 11 0 31 (6.4)
Smothering 5 0 0 5 13 0 3 0 0 0 0 0 13 13 0 26 (5.3)
Crushing asphyxia 0 0 0 0 1 0 9 1 0 0 0 0 9 2 0 11 (2.3)
Postural asphyxia 0 0 0 0 0 0 8 1 0 0 0 0 8 1 0 9 (1.8)
Oxygen deficiency 3 1 0 0 0 0 10 00 0 0 1 0 13 2 0 15 (3.1)
Others 0 0 0 3 2 0 1 0 0 2 0 0 6 2 0 8 (1.6)
Subtotal 178 125 10 28 78 0 51 14 1 2 1 0 259 218 11  
  (36.5) (25.6) (2.0) (5.7) (16.0) (0) (10.5) (2.9) (0.2) (0.4) (0.2) (0) (53.1) (44.7) (2.2) 488 (100)
Total 313 (64.1) 106 (21.7) 66 (13.6) 3 (0.6) 488 (100) -

Values are presented as number (%).

M, male; F, female; NI, not identified.

Cause of death in poisoning of legal autopsies performed in Korea in 2014

Cause of death Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Ethanol 0 1 0 0 0 0 30 22 0 0 0 0 30 23 0 53 (12.0)
Carbon monoxide 60 26 0 4 2 0 31 17 0 2 3 0 97 48 0 145 (32.6)
Cyanides 19 3 0 0 0 0 0 0 0 0 0 0 19 3 0 22 (5.0)
Agrochemicals 56 15 1 1 1 0 1 1 0 4 3 0 62 20 1 83 (18.7)
Narcotics 0 0 0 0 0 0 3 1 0 1 0 0 4 1 0 5 (1.1)
Therapeutic drugs 36 38 0 1 2 0 7 8 0 7 9 0 51 57 0 108 (24.4)
Organic solvents 8 5 0 0 0 0 0 0 0 1 0 0 9 5 0 14 (3.2)
Combined 1 0 0 0 0 0 0 2 0 0 0 0 1 2 0 3 (0.7)
Others 2 0 0 0 0 0 6 1 0 1 0 0 9 1 0 10 (2.3)
Subtotal 182 88 1 6 5 0 78 52 0 16 15 0 282 160 1  
  (41.1) (19.9) (0.2) (1.4) (1.1) (0) (17.6) (11.7) (0) (3.6) (3.4) (0) (63.7) (36.1) (0.2) 443 (100)
Total 271 (61.2) 11 (2.5) 130 (29.3) 31 (7.0) 443 (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 in 2014

Cause of death Suicide Homicide Accident Undetermined Subtotal Total
M F NI M F NI M F NI M F NI M F NI
Fire 33 6 0 8 9 0 105 55 2 38 19 2 184 89 4 277 (82.0)
Burn 2 0 0 0 0 0 6 2 0 1 1 0 9 3 0 12 (3.6)
Heat stroke 0 0 0 0 0 0 2 1 0 0 0 0 2 1 0 3 (0.9)
Hypothermia 0 0 0 0 0 0 31 15 0 0 0 0 31 15 0 46 (13.6)
Subtotal 35 6 0 8 9 0 144 73 2 39 20 2 226 108 4  
  (10.4) (1.8) (0) (2.4) (2.7) (0) (42.5) (21.6) (0.6) (11.5) (5.9) (0.6) (66.8) (32.0) (1.2) 338 (100)
Total 41 (12.2) 17 (5.1) 219 (64.7) 61 (18.0) 338 (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 in 2014

  Cause of death Male Female Subtotal Total
Heart Ischemic disease 588 72 660 (66.1) 998 (49.0)
Myocardial disease 29 11 40 (4.0)  
Valvular disease 1 0 1 (0.1)  
Others 238 59 297 (29.8)  
Vascular system Cerebral vessel 155 84 239 (67.6) 354 (17.3)
Aorta 27 13 40 (11.3)  
Pulmonary vessel 16 16 32 (9.0)  
Esophageal varix 31 8 39 (11.0)  
Others 4 0 5(1.1)  
Respiratory system Larynx/pharynx 2 0 2 (3.3) 61 (3.0)
Trachea 1 0 1(1.6)  
Lung 41 17 58 (95.1)  
Others 0 0 0 (0)  
Digestive tract Stomach/intestine 35 6 41 (27.5) 149 (7.3)
Liver 75 22 97 (65.1)  
Pancreas 5 5 10 (6.7)  
Others 1 0 1 (0.7)  
Endocrine/nutritional /metabolic disorder Chronic alcoholism 117 32 149 (74.1) 201 (9.8)
Diabetes 25 13 38 (8.9)  
Others 3 11 14 (7.0)  
Pregnancy/puerperium /delivery Hemorrhage 0 4 4 (30.8) 13 (0.6)
Embolism 0 4 4 (30.8)  
Hypertensive disorder 0 1 1 (7.6)  
Others 0 4 4 (30.8)  
Perinatal conditions Hypoxia 9 7 16 (69.6) 23 (1.1)
Others 2 5 7 (30.4)  
Miscellaneous Ill-defined mortality   67 46 113 (100) 113 (5.5)
SMDS 32 3 35 (26.9) 130 (6.4)
SIDS 20 17 37 (28.5)  
Unknown 48 10 58 (44.6)  
Total   1,572 (77.0) 470 (23.0)   2,042 (100)

Values are presented as number (%).

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 in 2014

  Cause of death Male Female Subtotal Total
Central nervous system Epilepsy 10 7 17 (81.0) 21
Encephalomeningitis 2 0 2 (9.5)  
Others 2 0 2 (9.5)  
Certain infection Septicemia 5 9 14 (48.3) 29
Tuberculosis 9 2 11 (37.9)  
Others 2 2 4 (13.8)  
Neoplasm Respiratory 3 4 7 (18.4) 38
Central nervous system 5 3 8 (21.1)  
Digestive 8 3 11 (28.9)  
Others 6 6 12 (31.6)  
Genitourinary disease Kidney 8 5 13 (92.9) 14
Others 0 1 1 (7.1)  
Congenital disease Heart 4 2 6 (75.0) 8
Others 1 1 2 (25.0)  
Others   2 1 3 (100) 3

Values are presented as number (%).

Manner of death in children under 10 of legal autopsies performed in Korea in 2014

Manner of death Neonatea) Infancyb) Preschoolc) Prepubertyd) Subtotal Total
M F M F M F M F M F
Unnatural 5 4 14 9 10 9 4 10 34 32 66 (38.8)
Suicide 0 0 0 0 0 0 0 0 0 0 0 (0)
Homicide 5 4 7 6 3 9 3 5 18 24 42 (24.6)
Accident 0 0 7 2 5 0 1 5 13 7 20 (11.8)
Undetermined 0 0 0 1 2 0 0 0 3 1 4 (2.4)
Natural 15 15 25 22 5 4 2 4 47 45 92 (54.1)
Unknown 2 0 6 2 1 1 1 0 9 3 12 (7.1)
Subtotal 22 19 45 33 16 14 7 14 90 80  
  (12.9) (11.2) (26.6) (19.4) (9.4) (8.2) (4.1) (8.2) (53.0) (47.0) 170 (100)
Total 41 (24.1) 78 (46.0) 30 (17.6) 21 (12.3) 170 (100) -

Values are presented as number (%).

M, male; F, female.

Neonate: birth-4 weeks;

Infancy: 1 month-1 year;

Preschool: 2-5 years;

Prepuberty: 6-9 years.

Analysis of unknown cause of death cases performed in Korea in 2014

Manner of death Case of unknown cause of death Total
Putrefied Skeletonized Infancya) Others
Unnatural 3 0 5 2 10 (2.9)
Suicide 1 0 0 0 1 (0.3)
Homicide 2 0 5 1 8 (2.3)
Accident 0 0 0 1 1 (0.3)
Undetermined 0 0 0 0 0 (0)
Natural 18 0 8 31 57 (16.3)
Unknown 155 58 9 62 284 (80.8)
Total 176 (50.0) 58 (16.5) 22 (6.3) 95 (27.2) 351 (100)

Values are presented as number (%).

Infancy: birth-1 year.

Deaths, unusual deaths and autopsies in Korea from 2012 to 2014

  Unusual/Death (%) Autopsies/Death (%) Autopsies/Unusual (%)
2012 2013 2014 2012 2013 2014 2012 2013 2014
Seoul 13.4 13.4 12.3 2.6 2.6 2.4 18.6 19.5 19.5
Busan 9.6 9.2 8.6 1.3 1.4 1.3 14.0 15.2 14.5
Incheon 14.2 13.3 12.6 3.3 3.1 3.1 23.0 23.6 24.1
Gwangju 13.9 13.4 13.6 1.5 1.5 1.7 10.7 10.7 12.7
Daejeon 15.5 14.7 14.8 1.2 1.3 2.2 7.7 8.5 14.6
Gyeonggi 15.3 15.3 14.1 2.5 2.7 2.9 16.6 17.4 20.4
Gangwon 16.2 15.7 14.9 1.5 1.8 1.9 9.2 11.6 12.6
Chungbuk 16.1 15.6 15.1 1.5 1.6 2.0 9.2 10.5 13.3
Chungnam 16.2 17.5 15.6 1.9 2.1 1.9 11.7 12.0 12.0
Jeonbuk 12.9 21.4 13.5 1.1 1.1 1.5 8.4 5.4 11.3
Jeonnam 13.0 16.9 13.2 1.7 1.5 2.0 12.8 8.9 15.2
Gyeongbuk 13.8 9.3 13.4 1.1 1.2 1.5 7.7 12.9 11.1
Gyeongnam 14.2 10.9 12.8 1.1 1.2 1.4 7.7 10.6 10.7
Total 14.2 14.0 13.1 1.9 1.8 2.1 13.5 13.0 16.0

Cause of death of legal autopsies in Korea from 2012 to 2014

Cause of death 2012 2013 2014
Unnatural Trauma 43.0 42.1 38.8
death Asphyxia 17.2 16.0 16.3
Drowning 12.5 14.4 15.0
Poisoning 11.5 12.9 14.8
Thermal injury 11.2 11.0 11.3
Electrocution 0.3 0.8 0.2
Starvation/neglect 0.3 0.8 0.2
Medical procedure 2.7 1.8 2.5
Anaphylaxis 0.3 0.0 0.1
Others 0.8 0.3 0.8
Natural Heart 50.2 52.0 49.0
death Vascular 16.7 16.9 17.3
Respiratory 3.1 3.0 3.0
Digestive 5.4 4.8 7.3
Endocrine/nutritional/metabolic 7.7 8.9 9.8
Pregnancy/puerperium/delivery 0.3 0.8 0.6
Perinatal 1.0 1.3 1.1
Miscellaneous 5.1 5.1 5.5
Ill-defined mortality 10.5 7.3 6.4

Values are presented as percentage.