缢死案例中与甲状舌骨损伤相关的因素：北非一项尸检研究
Factors associated with thyrohyoid injuries in hanging cases: An autopsy study in North Africa.
文献信息
| PMID | 42858700 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Narjes Karray |
| 作者单位 | Department of Forensic Medicine, University Hospital of Sfax, Sfax, Tunisia. |
| 期刊 | Journal of forensic and legal medicine |
| SCI 分区 | Q3 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 缢死是突尼斯最常见的自杀方式。其法医学评估需要综合死亡情境、现场勘查和完整尸检，以确定死亡原因和方式，并评估可能的第三方参与。在内部所见中，舌骨-喉复合体损伤具有特殊法医学意义，但其发生相关因素仍未完全明确。
目的： 本研究旨在识别缢死死亡中与甲状舌骨骨折相关的因素，并确定多因素分析后哪些因素仍与这些损伤独立相关。
材料与方法： 这项回顾性分析研究纳入了2020年1月至2022年12月期间在斯法克斯大学医院法医学系接受尸检的所有缢死所致机械性窒息病例。收集社会人口学数据、死亡情境、外部检查所见和尸检结果。采用单因素和多因素logistic回归识别甲状舌骨骨折的预测因素。
结果： 共纳入79例（平均年龄39.9±19.2岁，范围3-88岁；79.7%为男性）。大多数死亡发生在家中（74.7%）和冬季（35.4%）。完全性缢吊占45.6%，窄索具占46.8%。65.8%观察到颈部软组织出血，35.5%的病例发生甲状舌骨骨折。单因素分析显示，与年龄>40岁（OR 3.5；p=0.006）、体重>75 kg（OR 3.1；p=0.010）、完全性缢吊（OR 10.2；p<0.001）和窄索具（OR 4.4；p=0.004）存在显著关联。多因素分析证实，完全性缢吊（OR 43.4；p<0.001）和年龄>40岁（OR 5.3；p=0.043）是独立预测因素。
结论： 缢死中的甲状舌骨骨折与人口学因素和缢吊相关因素均有关。多因素分析后，年龄>40岁和完全性缢吊仍与这些损伤独立相关。这些发现可为解读甲状舌骨骨折提供有用的背景信息，但应结合死亡情境和完整尸检所见加以考虑。
英文摘要
BACKGROUND: Hanging is the most frequent method of suicide in Tunisia. Its medico-legal assessment requires an integrated approach combining the circumstances of death, scene investigation, and complete postmortem examination to establish the cause and manner of death and assess possible third-party involvement. Among the internal findings, injuries of the hyoid-laryngeal complex are of particular medico-legal interest, although the factors associated with their occurrence remain incompletely understood.
AIM: This study aimed to identify factors associated with thyrohyoid fractures in hanging deaths and to determine which factors remained independently associated with these injuries after multivariate analysis.
MATERIALS AND METHODS: This retrospective analytical study included all cases of mechanical asphyxia by hanging autopsied at the Department of Forensic Medicine, University Hospital Sfax, between January 2020 and December 2022. Socio-demographic data, death circumstances, external examination findings, and autopsy results were collected. Univariate and multivariate logistic regression were used to identify predictors of thyrohyoid fractures.
RESULTS: Seventy-nine cases were included (mean age 39.9 ± 19.2 years, range 3-88; 79.7% male). Most deaths occurred at home (74.7%) and during winter (35.4%). Complete hanging accounted for 45.6% and narrow ligatures for 46.8%. Cervical soft-tissue hemorrhages were observed in 65.8%, while thyrohyoid fractures occurred in 35.5% of cases. Univariate analysis showed significant associations with age >40 years (OR 3.5; p = 0.006), weight >75 kg (OR 3.1; p = 0.010), complete hanging (OR 10.2; p < 0.001), and narrow ligatures (OR 4.4; p = 0.004). Multivariate analysis confirmed complete hanging (OR 43.4; p < 0.001) and age >40 years (OR 5.3; p = 0.043) as independent predictors.
CONCLUSION: Thyrohyoid fractures in hanging were associated with both demographic and hanging-related factors. After multivariate analysis, age >40 years and complete hanging remained independently associated with these injuries. These findings may provide useful contextual information when interpreting thyrohyoid fractures but should be considered alongside the circumstances of death and complete autopsy findings.