Elevation of Postmortem Cerebrospinal Fluid Sodium and Chloride Levels Is a Potential Adjunct Test in the Diagnosis of Salt Water Drowning
| Autor: | Leo Lam, Winston Philcox, Sinead McCarthy, Kilak Kesha, Rexson Tse, Paul Morrow, Benjamin Ondruschka, Charley Glenn, Guillaume Rousseau, Sarah Hensby-Bennett, Simon Stables, Leah J. Clifton, Cristian Palmiere, Jack Garland, Hannah Elstub, Lina Woydt, Amy Spark, Allan Cala, Toni OʼRegan, Claire Barker |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Sodium chemistry.chemical_element Poison control Sensitivity and Specificity Gastroenterology Pathology and Forensic Medicine Young Adult Chloride levels Cerebrospinal fluid Chlorides Predictive Value of Tests Internal medicine medicine Humans Seawater Aged Retrospective Studies Aged 80 and over Drowning Receiver operating characteristic medicine.diagnostic_test business.industry Lumbar puncture Forensic Medicine Middle Aged chemistry Case-Control Studies Predictive value of tests Salt water Female business Biomarkers |
| Zdroj: | American Journal of Forensic Medicine & Pathology. 40:251-257 |
| ISSN: | 1533-404X 0195-7910 |
| Popis: | Postmortem vitreous humor biochemistry is a useful test in the diagnosis of salt water drowning (SWD). A significant limitation of vitreous humor is the potential effect of prolonged immersion. A recent animal study and case report suggested that cerebrospinal fluid biochemistry may be an alternative to vitreous because it is more resistant to the effects of immersion, given its protected anatomical location. This study compared postmortem cerebrospinal fluid sodium and chloride (PMCSC) levels collected via ventricular aspiration (PMCSC_V) and via lumbar puncture (PMCSC_L) in 13 SWD and 31 nonimmersion deaths. It showed a significant elevation in PMCSC levels in SWD deaths for both PMCSC_V and PMCSC_L (P < 0.05). The areas under the curve on the receiver operating characteristic curves for PMCSC_V and PMCSC_L were 0.73 and 0.83, respectively. The optimal cutoff for PMCSC_V was 216 mmol/L (sensitivity, 0.60; specificity, 0.72; likelihood ratio, 1.80; positive predictive value, 0.45) and for PMCSC_L was 241 mmol/L (sensitivity, 0.78; specificity, 0.73; likelihood ratio, 2.89; positive predictive value, 0.46). This study supports PMCSC levels as another biochemical test that can potentially aid in the diagnosis of SWD, particularly in cases where vitreous humor samples are unavailable or uninterpretable. |
| Databáze: | OpenAIRE |
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