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Na, Park, Yang, Chung, and Lee: A Classification of Asphyxia Autopsy Cases of the Korea in 2012 according to New Classification of Asphyxia
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Korean J Leg Med 2014;38(1):8-12.

Published online: 17 January 2014

DOI: https://doi.org/10.7580/kjlm.2014.38.1.8

A Classification of Asphyxia Autopsy Cases of the Korea in 2012 according to New Classification of Asphyxia

Joo Young Na1, Jong Pil Park2, Kyung-Moo Yang2, Nak-Eun Chung3, Han Young Lee2

1Forensic Medicine Division, Gwangju Institute of Scientific Investigation, Jangseong-gun, Jeollanam, Korea

2Forensic Medical Center, National Forensic Service, Wonju-si, Gangwon, Korea

3Department of Forensic Medicine Investigation, Seoul Institute of Scientific Investigation, Seoul, Korea

Presentation history: 본 논문은 2013. 11. 7-8. 개최된 제1회 한국포렌식연합회 공 동학술대회에서 연제로 발표되었음을 밝 힘. 책임저자 : 나주영 (515-822) 전라남도 장성군 서삼면 축령 로 687, 광주과학수사연구소 법의학과 전화 : +82-61-393-8442 FAX : +82-61-393-8440 E-mail : pdrdream@gmail.com

Received 21 January 2014       Revised 14 February 2014       Accepted 19 February 2014

Copyright © 2014 The Korean Society for Legal Medicine

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

No accepted standard currently exists to classify asphyxia and define its subtypes. Sauvageau and Boghossian proposed an asphyxia classification system in 2010 that divided asphyxia into suffocation, strangulation, mechanical asphyxia, and drowning. Here, we present a modification of this classification system. We propose to classify asphyxia into four main categories: suffocation, strangulation, mechanical asphyxia, and complicated asphyxia. Suffocation includes smothering and choking as well as confined spaces, entrapment, and vitiated atmosphere. Strangulation is subdivided into hanging, ligature strangulation, manual strangulation, and other unspecified strangulation. Mechanical asphyxia includes positional and traumatic asphyxia. Finally, complicated asphyxia is defined as cases with two or more identifiable mechanisms of asphyxia. In this study, we review autopsy cases from 2012 diagnosed as asphyxia and classify them according to our proposed asphyxia classification system. In 24.7% of cases, the age range was 40-49 years, and 51.9% were men. The most common method of asphyxia was hanging (245 cases, 55.1%), followed by ligature or manual strangulation (53 cases, 11.9%). Most hangings were suicides; smothering, ligature, and manual strangulation were usually homicides. Eighteen cases were complicated asphyxia. This classification provides a simplified, unified, and useful tool to classify and understand deaths due to asphyxia.

Keywords: Key Words, Asphyxia, Autopsy, Classification, Korea

REFERENCES

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Fig. 1.
The classification of asphyxia used in this study is shown.
kjlm-38-8f1.tif
Table 1.
Age, Sex, and Subtypes of Asphyxia Autopsies Performed in Korea during the Year 2012
Asphyxia Age Sex <9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80< NI∗ Subtotal Total l (%)
M F M F M F M F M F M F M F M F M F M F NI∗ M F
Suffocation 9 13 1 1 6 2 4 0 8 2 10 1 2 1 1 2 0 1 0 0 0 41 23 64 14.4
 Smothering 8 8 0 0 2 1 1 0 2 1 4 1 0 0 0 0 0 1 0 0 0 17 12 29 45.3
 Chocking 1 5 1 1 2 1 2 0 4 1 4 0 2 1 1 2 0 0 0 0 0 17 11 28 43.8
 Deficient 0 0 0 0 2 0 1 0 2 0 2 0 0 0 0 0 0 0 0 0 0 7 0 7 10.9
Strangulation 4 4 6 3 15 27 25 49 51 38 42 22 21 9 4 13 3 6 9 1 4 180 172 356 80.0
 Hanging 1 1 1 0 13 18 22 38 40 21 35 14 15 4 1 2 3 2 9 1 4 140 101 245 68.8
 Ligture stangulation 2 0 3 1 1 2 0 4 6 7 5 2 5 2 3 7 0 3 0 0 0 25 28 53 14.9
 Manual strangulation 1 3 2 2 1 7 2 7 2 10 1 6 1 3 0 4 0 1 0 0 0 10 43 53 14.9
 Straungulation, NOS 0 0 0 0 0 0 1 0 3 0 1 0 0 0 0 0 0 0 0 0 0 5 0 5 1.4
Mechanial asphyxia 0 0 0 0 1 0 0 0 2 2 1 0 1 0 0 0 0 0 0 0 0 5 2 7 1.6
 Positional asphyxia 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 2 28.6
 Compressive asphyxia 0 0 0 0 1 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 4 1 5 71.4
Complicated asphyxia 0 3 0 0 1 0 1 2 2 5 0 2 1 0 0 1 0 0 0 0 0 5 13 18 4.0
Subtotal 13 20 7 4 23 29 30 51 63 47 53 25 25 10 5 16 3 7 9 1 4 231 210 445 100.0
Total 33 11 52 81 110 78 35 21 10   14 445    
(%) 7.4 2.5 11.7 18.2 24.7 17.5 7.9 4.7 2.2   3.1 100.0    

∗ NI: Not identified;

† NOS: Not otherwise specified

Table 2.
Cause and Manner of Death in Asphyxia of Legal Autopsies Performed in Korea during the Year 2012
  Sex Sucide Homicide Accident Undetermined Subtotal Total (%)
M F NI∗ M F NI∗ M F NI∗ M F NI∗ M F NI∗    
Suffocation 6 5 0 11 6 0 24 12 0 0 0 0 41 23 0 64 14.4
 Smothering 3 5 0 11 6 0 3 1 0 0 0 0 17 12 0 29 45.3
 Chocking 0 0 0 0 0 0 17 11 0 0 0 0 17 11 0 28 43.8
 Deficient 3 0 0 0 0 0 4 0 0 0 0 0 7 0 0 7 10.9
Strangulation 149 115 4 20 55 0 8 1 0 3 1 0 180 172 4 356 80.0
 Hanging 138 100 4 0 0 0 1 1 0 1 0 0 140 101 4 245 68.8
 Ligture stangulation 11 15 0 12 12 0 1 0 0 1 1 0 25 28 0 53 14.9
 Manual strangulation 0 0 0 8 43 0 1 0 0 1 0 0 10 43 0 53 14.9
 Straungulation, NOS† 0 0 0 0 0 0 5 0 0 0 0 0 5 0 0 5 1.4
Mechanial asphyxia 1 0 0 0 0 0 4 2 0 0 0 0 5 2 0 7 1.6
 Positional asphyxia 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 2 28.6
 Compressive asphyxia 1 0 0 0 0 0 3 1 0 0 0 0 4 1 0 5 71.4
Complicated asphyxia 1 1 0 2 11 0 2 1 0 0 0 0 5 13 0 18 4.0
 Subtotal 157 121 4 33 72 0 38 16 0 3 1 0 231 210 4 445 100.0
 (%) 35.3 27.2 0.9 7.4 16.2 0.0 8.5 3.6 0.0 0.7 0.2 0.0 51.9 47.2 0.9 100.0 0
 Total   282     105     54     4     445      
 (%)   63.4     23.6     12.1     0.9     100.0      

∗ NI: Not identified;

† NOS: Not otherwise specified

Table 3.
Cause and Manner of Death in Complicated Asphyxia Cases Performed in Korea during the Year 2012
Asphyxia Sucide Homicide Accident Undetermined Sum of case number
Suffocation
 Smothering #10∗, #12, #1, #6, #7, #13 #4, #8, #9, #14, #15   10
 Chocking     #8, #14   2
 Deficient         0
Strangulation
 Hanging   #5   #2 2
 Ligture stangulation #10, #12 #3, #11, #13, #16, #17, #18   #2 9
 Manual strangulation   #3, #5, #6, #7, #11, #16, #17, #18     8
 Straungulation, NOS†         0
Mechanial asphyxia
 Positional asphyxia   #1 #14   2
 Compressive asphyxia   #1 #4, #9, #15   4
Sum of case 2 10 5 1  

∗ : Case number;

† NOS: Not otherwise specified

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