Abstract In forensic casework, investigation of injury severity in traffic accidents is important for evaluating the mortality, occasionally
in terms of the adequacy of clinical management. The present study evaluated 5 cases of clinically unexpected delayed collapse
followed by death using the abbreviated injury scale (AIS), injury severity score (ISS), and a clinical trauma care method
(trauma and injury severity score, TRISS). In these cases, major injury (AIS = 3–5) was found in the head, chest and/or abdomen
at autopsy, and ISS was estimated to be 11–45 (serious to critical but not incompatible with life). By the TRISS method, the
probability of survival (P
s) was estimated to be >0.5 for all cases (0.60–0.99), suggesting that these were preventable deaths. However, the present
cases showed several common features: (a) fatality due to closed injury/-ies to the thoracic and/or abdominal viscera, (b)
alert and poor symptoms/clinical signs, and (c) poor positive findings in diagnostic imaging at early times after injury,
and (d) complications of other evident injuries, suggesting difficulties in the clinical diagnosis of potentially fatal injuries,
but (e) possibly predictable fatal injury when typical patterns of traffic accident injury were considered.
Content Type Journal ArticleCategory Case ReportDOI 10.1007/s12024-007-9025-5Authors
Tomomi Michiue, Osaka City University Medical School Department of Legal Medicine Asahi-machi 1-4-3, Abeno Osaka 545-8585 JapanTakaki Ishikawa, Osaka City University Medical School Department of Legal Medicine Asahi-machi 1-4-3, Abeno Osaka 545-8585 JapanLi Quan, Osaka City University Medical School Department of Legal Medicine Asahi-machi 1-4-3, Abeno Osaka 545-8585 JapanBao-Li Zhu, Osaka City University Medical School Department of Legal Medicine Asahi-machi 1-4-3, Abeno Osaka 545-8585 JapanHitoshi Maeda, Osaka City University Medical School Department of Legal Medicine Asahi-machi 1-4-3, Abeno Osaka 545-8585 Japan
Journal Forensic Science, Medicine, and PathologyOnline ISSN 1556-2891Print ISSN 1547-769X (Source: Forensic Science, Medicine, and Pathology)