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2018 ; 33
(14
): e108
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Bath-related Deaths in Korea between 2008-2015
#MMPMID29607634
Yang K
; Choi BH
; Lee B
; Yoo SH
J Korean Med Sci
2018[Apr]; 33
(14
): e108
PMID29607634
show ga
BACKGROUND: The diagnostic criteria for bathtub drownings are not standardized,
and the risk factors associated with bath-related deaths are unclear. METHODS: We
analyzed a Korean nationwide database of bath-related deaths that occurred
between January 2008 and December 2015. Eighty-four cases were enrolled after
reviewing 31,123 autopsy records. RESULTS: The subjects' ages ranged from 18 to
91 years, with a mean age ± standard deviation of 61.3 ± 16.0 years. Bath-related
deaths in the winter were approximately 4.6-fold greater than those in the
summer. Of the 84 subjects, the primary cause of death in 57 (67.9%) was drowning
in the bath; 24 (28.6%) drowned of other causes such as natural diseases, and 3
(3.6%) died of acute alcohol intoxication. We analyzed water-inhalation signs to
establish criteria for bathtub drowning diagnosis. There were significantly
higher incidences of hyperinflated lungs, water in the sphenoid sinus and
stomach/duodenal contents, and Paltauf's spots (subpleural hemorrhage) in
bathtub-drowned subjects compared to non-drowned individuals (P < 0.01). Multiple
signs of water inhalation were significantly associated with bathtub drowning (P
< 0.01). The two leading contributory causes of bath-related death were
cardiovascular diseases and alcohol intoxication (binge drinking before bathing).
CONCLUSION: The diagnosis of bath-related deaths could present considerable
medico-legal problems; therefore, a comprehensive autopsy with a thorough scene
investigation can clarify the cause of death in these situations. Preventive
strategies for reducing such deaths should target alcohol drinking before bathing
and long soaking times in bathtubs, especially among elderly individuals with
preexisting cardiovascular diseases.
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