The role of paranasal sinus fluid in determining drowning as the cause of death: A systematic review and meta-analysis.

Autor: da Trindade RQ; Graduate Program in Oral Biology, Piracicaba Dental School, State University of Campinas, UNICAMP, São Paulo, Brazil., Duarte Morais Vieira MG; Graduate Program in Oral Biology, Piracicaba Dental School, State University of Campinas, UNICAMP, São Paulo, Brazil., Vieira RB; Graduate Program in Pathology, Ribeirão Preto Medical School, University of São Paulo, USP, São Paulo, Brazil., Vicentin-Junior CA; Graduate Program in Pathology, Ribeirão Preto Medical School, University of São Paulo, USP, São Paulo, Brazil., Damascena NP; Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil., Santiago BM; Graduate Program in Dentistry, Federal University of Paraiba, Paraiba, Brazil., Martins-Filho PR; Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil; Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil. Electronic address: prmartinsfh@gmail.com., Palhares Machado CE; National Institute of Criminalistics, Brazilian Federal Police, Distrito Federal, Brazil.
Jazyk: angličtina
Zdroj: Journal of forensic and legal medicine [J Forensic Leg Med] 2023 Oct; Vol. 99, pp. 102591. Date of Electronic Publication: 2023 Sep 12.
DOI: 10.1016/j.jflm.2023.102591
Abstrakt: Drowning is a significant global cause of unintentional injury fatalities, and accurate forensic diagnosis of drowning remains a challenge due to the nonspecific nature of post-mortem findings obtained through classical autopsy methods. Our manuscript addresses this issue by focusing on the emerging use of paranasal sinus fluid as a valuable tool in determining the cause of death, specifically in distinguishing drowning from non-drowning cases. The study provided a comprehensive summary of available evidence from observational studies that compared findings in the paranasal sinuses between drowning and non-drowning victims, analyzing parameters such as the presence of fluid, fluid volume, and density. The study encompassed a total of 14 selected studies involving 1044 subjects and utilized rigorous risk of bias assessment and data synthesis techniques. The meta-analysis demonstrated a strong association between the presence of fluid in the paranasal sinuses and drowning (OR = 17.1; 95% CI 7.2 to 40.5; p < 0.001). In addition, drowning victims had a significantly greater volume of fluid (SMD = 0.8; 95% CI 0.5 to 1.2; p < 0.001) and lower fluid density (SMD = -1.4; 95% -2.5 to -0.4; p = 0.008) compared to non-drowning cases. The results support the utility of paranasal sinus fluid analysis as a valuable diagnostic method in cases where drowning is suspected but cannot be definitively confirmed through traditional approaches.
Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest.
(Copyright © 2023 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)
Databáze: MEDLINE
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