Retrospective mortality study of unnatural deaths in the 65+ generation based on autopsies at the Institute of Legal Medicine in Frankfurt am Main during two periods

Abstract

Background and aim of the study: Changes in the age spectrum of autopsy data are to be expected because of the demographic change. The aim of the present work was to examine the unnatural deaths of the deceased who had reached a minimum age of 65 years, as this population group will be of increasing importance in the future. Material and methods: In this retrospective mortality study autopsy reports of the Institute of Legal Medicine, University Hospital of the Goethe University Frankfurt/Main, Germany, were retrospectively analyzed with respect to unnatural death cases of people ≥ 65-year-old in a time comparison (period I: 2000–2002; period II: 2013–2015). For the analysis of the deceased who committed suicide, data of non-autopsied suicide cases (n = 100) obtained by external examination of the corpse only were also included. Results: The analysis of 1206 autopsy reports resulted in 669 natural (55.5%) and 404 unnatural (33.5%) deaths. This included 221 accidents (period I, n = 105; period II, n = 116), 82 suicides (period I, n = 55; period II, n = 27), 41 deaths associated with medical treatment (period I, n = 7; period II, n = 34) and 40 homicides (period I, n = 23; period II, n = 17). Among the accidents, traffic and fall accidents represented the largest subgroups. Hanging and shooting were the main suicide methods. By comparing the data of periods I and II, a significant increase in deaths related to medical interventions is noted. The reason for the significant decrease in the number of suicides is explained by the decreasing autopsy rate in this group. On the other hand, the autopsy data of the relative and absolute number of homicides revealed no significant changes. Conclusion: Most of the results obtained by the present study are in line with data from the literature. Over the time, a relative increase in unnatural deaths was noted when evaluating gerontologic autopsy data. This is mainly due to the increasing number of autopsies prompted by iatrogenic complications.