Diagnostic Challenges in Determining Cause of Death in Decomposed Bodies

Abstract

Background: Determining the cause of death in decomposed bodies presents significant challenges due to decomposition’s alteration of anatomical and physiological characteristics, affecting forensic investigations and impeding the identification of trauma or disease. Objective: This study aims to evaluate diagnostic challenges in determining the cause of death in decomposed bodies, focusing on the limitations of postmortem methodologies and their effectiveness in revealing trauma, disease, and toxicological evidence. Methods: A cross-sectional study was conducted on 72 decomposed bodies submitted by police after case filing from different police station at the Department of Forensic Medicine & Toxicology morgue, RMC, Rajshahi for Postmortem Examination, from June 2023 to December 2024. Postmortem analyses included histopathology, toxicology of body sample like hair, bones, nails, body fluid, teeth etc, chemical analysis of viscera and blood and entomology. Statistical analyses were conducted using Chi-square, t-tests, Pearson correlation, and regression models. Results: Of the 72 bodies, 45% (n=32) had unresolved causes of death due to severe decomposition (p=0.03). Toxicological analysis failed in 38% (n=27) of cases, while 25% (n=18) showed inadequate histopathological evidence, fractures detected in 22% (n=16), but 78% (n=56) showed no visible trauma. The postmortem interval (PMI) estimation using entomology had a mean deviation of 2.5 days (SD=1.8), with a correlation coefficient of 0.72 (p<0.01) between temperature and decomposition rate, with 90% (p<0.05) accuracy for moderate decomposition, dropping to 65% (p=0.08) in advanced decomposition. Regression analysis found a significant relationship (r=0.65, p<0.01) between environmental humidity and tissue breakdown, with increased humidity leading to a faster decomposition rate. A significant difference (p=0.02) in trauma detection was found between bodies decomposed for over 30 days and those under 30 days, indicating a threshold at which forensic examination becomes unreliable. Conclusion: Advanced decomposition impairs the accuracy of traditional postmortem diagnostic methods. Despite technological advancements in imaging, environmental factors and the stage of decomposition significantly affect the reliability of forensic investigations.