Author/Editor		Kadiš, Peter
Title		Alkoholna ketoacidoza kot možen vzrok smrti kroničnih alkoholikov
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2001
Volume		str. 80
Language		slo
Abstract		Due to uncertain cause of sudden deaths of chronic alcoholics such cases are commonly investigated in forensic pathology. However, this cause remains undetermined in 10 to 20 % of all cases despite of careful postmortem examinations comprising autopsy, histological, alcoholimetric and toxicological analyses. By selected foreign reports the cause of death in some of these cases could be alcoholic ketoacidosis and hypoglycemia due to coincidence of alcoholic abuse and starvation. Alcoholic ketoacidosis so as hypoglycemia couldn't be directly proved postrnortem due to autolytic processes, but beta-hydroxybutyric acid (beta-HBA) as a specific postmortem indicator of fatal alcoholic ketoacidosis could be determined. In this prospective study we analyzed the cause of death, liver pathology and (3- HBA concentration in postmortem blood, urine, cerebrospinal fluid and vitreous humor of 50 suddenly deceased chronic alcoholics. The control group comprised 30 cases of suddenly deceased nonalcoholics. Forensic autopsy, histological, alcoholimetric and toxicological analyses were performed in all of these cases. The main causes of death in chronic alcoholics were cardiovascular diseases, respiratory infections, gastrointestinal bleeding, suicides and acute ethanol intoxication. In 10 cases or 20 % of cases where the cause of death remained unclear and unexplained by conventional examination, the levels of beta-HBA were pathologically increased in blood, vitreous humor and urine (over 2000 micro mol/1). The measwements were significantly higher than in the group of chronic alcoholics with the known cause of death and the control group (p< 0,001). The levels of beta- HBA in cerebrospinal fluid were not statistically significant in the both groups of chronic alcoholics and in the control group as well. (Abstract truncated at 2000 characters).
Descriptors		ALCOHOLISM CAUSE OF DEATH DEATH, SUDDEN FORENSIC MEDICINE AUTOPSY ACIDOSIS KETOSIS HYDROXYBUTYRATES LIVER DISEASES, ALCOHOLIC SEX FACTORS AGE FACTORS BODY FLUIDS