TY - JOUR
T1 - Availability of death review of children using death certificates and forensic autopsy results
AU - Ito, Eisuke
AU - Hitosugi, Masahito
AU - Maruo, Yoshihiro
AU - Nakamura, Mami
AU - Takaso, Marin
AU - Masumitsu, Akane
AU - Baba, Mineko
N1 - Funding Information:
We thank all members of the Council for Promoting Determination of Correct Cause of Death in Shiga for promoting reviews of children's deaths. We also thank Prof. Yuichiro Yano for help with the statistical analysis. Conflicts of Interest: The authors declare that there are no conflicts of interest. Funding: This research received no external funding. Institutional Review Board Statement: This study was conducted following approval from the Ethical Committee of Shiga University of Medical Science (R2020-164).
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2023/2
Y1 - 2023/2
N2 - The Model Project for Child Death Review (CDR) was initiated in Japan, but parental consent is required for detailed investigations. We proposed an alternative method to review child deaths using death certificates and forensic autopsy results when parental consent is not provided. We extracted and reviewed death certificates for the deceased younger than 18 years from among all certificates submitted in Shiga Prefecture between 2015 and 2017. In addition, we analyzed autopsy records in cases that underwent forensic autopsy. The prevalence of each cause of death was compared among age groups. The situation and circumstances of unnatural deaths were analyzed in detail. Of 131 certificates, unnatural deaths accounted for 29.7 %. The prevalence of each cause of death significantly differed among age groups. Malignant disease and suicide were most common in school-aged children and congenital disease was most common in infants. Suicide was the leading cause of unnatural death, followed by suffocation, which was most common in infants. Situations where suffocation was reported included co-sleeping with the mother and breastfeeding. Despite parental consent not being obtained, the trends of regional child deaths and the circumstances of accidental deaths were clarified by the present method. However, the results of detailed investigation were lacking. This study provided basic information for implementing detailed methods and procedures for CDR at the governmental level. To perform optimal CDR, legislation for collecting detailed information without parental consent is required.
AB - The Model Project for Child Death Review (CDR) was initiated in Japan, but parental consent is required for detailed investigations. We proposed an alternative method to review child deaths using death certificates and forensic autopsy results when parental consent is not provided. We extracted and reviewed death certificates for the deceased younger than 18 years from among all certificates submitted in Shiga Prefecture between 2015 and 2017. In addition, we analyzed autopsy records in cases that underwent forensic autopsy. The prevalence of each cause of death was compared among age groups. The situation and circumstances of unnatural deaths were analyzed in detail. Of 131 certificates, unnatural deaths accounted for 29.7 %. The prevalence of each cause of death significantly differed among age groups. Malignant disease and suicide were most common in school-aged children and congenital disease was most common in infants. Suicide was the leading cause of unnatural death, followed by suffocation, which was most common in infants. Situations where suffocation was reported included co-sleeping with the mother and breastfeeding. Despite parental consent not being obtained, the trends of regional child deaths and the circumstances of accidental deaths were clarified by the present method. However, the results of detailed investigation were lacking. This study provided basic information for implementing detailed methods and procedures for CDR at the governmental level. To perform optimal CDR, legislation for collecting detailed information without parental consent is required.
KW - Child Death Review (CDR)
KW - Death certificate
KW - Forensic autopsy
KW - Preventable child death
KW - Sleeping environment
KW - Suffocation
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U2 - 10.1016/j.legalmed.2022.102156
DO - 10.1016/j.legalmed.2022.102156
M3 - Article
C2 - 36270202
AN - SCOPUS:85140095714
SN - 1344-6223
VL - 60
JO - Legal Medicine
JF - Legal Medicine
M1 - 102156
ER -