Postmortem serum erythropoietin level as a marker of survival time in injury deaths.

Abstract

Circulating erythropoietin (EPO) is mainly derived from the kidneys, and the serum concentration is rapidly increased in response to anemia and hypoxia. The present study investigated postmortem serum EPO levels in injury death cases (n=185, postmortem time<48 h, survival time <7 days: sharp instrument injury, n=44 and blunt injury, n=141) with regard to survival time, compared with C-reactive protein (CRP) as a marker of inflammation. Serum levels of both markers were independent of postmortem time. A survival time-dependent increase in serum EPO up to about 100 mU/ml was seen within 6h of sharp instrument injury to the heart or a proximal major vessel (thoracic aorta or subclavian/carotid artery) and blunt injury with massive hemorrhages, showing high correlations (r=0.957 and r=0.822, respectively, P<0.0001), whereas the increase was insignificant (P>0.05) for sharp instrument injury to a peripheral vessel or lungs/abdominal viscera and blunt injury with minor hemorrhages over the same survival period. A further increase (>100 mU/ml) was often detected in cases of death about 24h after blunt injury, irrespective of the type of injury. In contrast, a gradual increase in serum CRP level was seen about 12-24h after blunt injury. These findings suggest that serum EPO can be a marker for investigating survival time within 6h of major injury involving acute massive hemorrhaging.

• Authors: L Quan, B-L Zhu, T Ishikawa, T Michiue, D Zhao, M Ogawa, H Maeda
• Journal: Forensic science international (Forensic Sci Int) Vol. 200 Issue 1-3 Pg. 117-22 (Jul 15 2010) ISSN: 1872-6283 [Electronic] Ireland
• PMID: 20430543 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Biomarkers
• Erythropoietin
• C-Reactive Protein

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers (blood)
• C-Reactive Protein (analysis)
• Case-Control Studies
• Erythropoietin (blood)
• Female
• Forensic Pathology
• Hemorrhage (blood, pathology)
• Humans
• Male
• Middle Aged
• Postmortem Changes
• Survival Analysis
• Wounds, Nonpenetrating (blood, pathology)
• Wounds, Stab (blood, pathology)