An analysis of the pathological features of hypothermia based on two geographically separate populations

Abstract

Aims To review deaths attributed to hypothermia between 2006 and 2011. Results There were 16 cases from Berlin (age 38-96 years; average 68 years; M:F = 13:3). Twelve deaths (75%) occurred indoors, and four (25%) outdoors. Autopsy findings: Wischnewski spots, 16 cases (100%); discolouration of skin over the major joints, nine cases (56%); and acute pancreatitis and psoas muscle haemorrhage, one case each (6%). There were 62 cases from Adelaide (age 30-86 years; average 67 years; M:F = 13:18). Fifty-two deaths (84%) occurred indoors, and 10 (16%) outdoors. Autopsy findings: Wischnewski spots, 57 cases (92%); discolouration of skin over the major joints, seven cases (11%); basal vacuolisation of renal tubular epithelial cells, six cases (10%); and acute pancreatitis, one case (2%). Discussion The reporting of autopsy findings in hypothermic deaths may be influenced by a number of factors, including the location and nature of these deaths and the reliance that is placed on finding particular pathological features. It is also possible that that the aetiology of these markers is quite complex and involves not only a significant reduction in core temperature, but the variable and poorly-understood interaction of a number of other factors.