Evaluation of Postmortem Serum Insulin-Like Growth Factor 1 Levels in Traumatic Deaths With Regard to the Survival Time and Severity of Trauma

Abo El-Noor, Mona; Elgazzar, Fatma M.; El-Shafy, Ghada H.

doi:10.21608/mjfmct.2016.47925

Evaluation of Postmortem Serum Insulin-Like Growth Factor 1 Levels in Traumatic Deaths With Regard to the Survival Time and Severity of Trauma

Document Type : Original Article

Authors

¹ Forensic Medicine and Clinical Toxicology, Department, Faculty of Medicine, Tanta University, Tanta, Egypt

² Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt,

³ Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

10.21608/mjfmct.2016.47925

Abstract

Several clinical studies showed reduced levels of circulating insulin-like growth factor 1(IGF-1) in patients with acute trauma. The aim of this study was to investigate postmortem serum IGF-1 levels in traumatic deaths with special regard to the survival time and severity of trauma. This study was carried out on eighty cases of mechanical traumatic deaths subjected to medicolegal autopsy in El-Mansura Department of Forensic Institute during the period from the start of January 2014 to the end of October 2015. Only adult males aged 18 years or more were included. Decomposed bodies and/or those with no confirmed survival period were excluded. For each case, the age, cause and site of trauma, survival period and the cause of death were reported. Additionally, Rt cardiac blood samples were taken using sterile syringes for determination of IGF-1 levels. According to the affected body region, cases were grouped in to: group1 (isolated head trauma, n=20), group 2 (body trauma without head trauma, n=30), and group 3 (combined head and other regional body trauma, n=30). A control group of ten male cases with nontraumatic natural deaths matched for age were selected. There was significant decrease in IGF-1 levels in all the studied groups of traumatic deaths compared to the control group. Additionally, mean IGF-1 levels in group 3 were significantly lower compared to groups 1 and 2. In all the studied groups, there was significant negative correlation between serum IGF-1 levels and the survival time (hs) and prediction of survival time (hs) was determined by simple linear regression analysis. A significant negative correlation was also detected between IGF-1 levels and the total abbreviated injury scale (AIS). In conclusion, this study demonstrated for the first time low postmortem serum IGF-1 levels in males died from mechanical trauma with significant negative correlation with the survival time and trauma severity.

Keywords