Point-of-care hemoglobin testing for postmortem diagnosis of anemia
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ORIGINAL ARTICLE
Point-of-care hemoglobin testing for postmortem diagnosis of anemia Joo-Young Na 1 & Ji Hye Park 2 & Byung Ha Choi 3 & Hyung-Seok Kim 4 & Jong-Tae Park 4
Accepted: 2 January 2018 # Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract An autopsy involves examination of a body using invasive methods such as dissection, and includes various tests using samples procured during dissection. During medicolegal autopsies, the blood carboxyhemoglobin concentration is commonly measured using the AVOXimeter® 4000 as a point-of-care test. When evaluating the body following hypovolemic shock, characteristics such as reduced livor mortis or an anemic appearance of the viscera can be identified, but these observations arequite subjective. Thus, a more objective test is required for the postmortem diagnosis of anemia. In the present study, the AVOXimeter® 4000 was used to investigate the utility of point-ofcare hemoglobin testing. Hemoglobin tests were performed in 93 autopsy cases. The AVOXimeter® 4000 and the BC2800 Auto Hematology Analyzer were used to test identical samples in 29 of these cases. The results of hemoglobin tests performed with these two devices were statistically similar (r = 0.969). The results of hemoglobin tests using postmortem blood were compared with antemortem test results from medical records from 31 cases, and these results were similar. In 13 of 17 cases of death from internal hemorrhage, hemoglobin levels were lower in the cardiac blood than in blood from the affected body cavity, likely due to compensatory changes induced by antemortem hemorrhage. It is concluded that blood hemoglobin testing may be useful as a point-of-care test for diagnosing postmortem anemia. Keywords Hemoglobin . Point-of-care testing . Autopsy . Anemia
Introduction The autopsy is the gold standard procedure for investigating death. In addition to invasive methods such as dissection, this procedure involves postmortem laboratory tests performed using samples procured during dissection, which commonly include bodily fluids. Previous
* Jong-Tae Park [email protected] 1
Biomedical Research Institute, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea
2
Forensic Medicine Division, National Forensic Service Gwangju Institute, 687, Chungnyeong-ro, Seosam-myeon, Jangsung 57231, Republic of Korea
3
Medical Examiner’s Office, National Forensic Service, 10, Ipchun-ro, Wonju 26460, Republic of Korea
4
Department of Forensic Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea
studies have shown postmortem laboratory tests to be useful, despite their myriad of limitations [1, 2]. Various tests are available for evaluating body fluids obtained postmortem. Vitreous humor is used in postmortem laboratory tests for determining levels of urea, nitrogen, creatinine, glucose, and electrolytes, whereas blood samples are used in tests for C-reactive peptide and other markers. Recently, several po
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