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Increased lung weight in fatal intoxications is not unique to opioid drugs

Beer, Torfinn ; Eriksson, Anders and Wingren, Carl Johan LU (2023) In Journal of Forensic Sciences 68(2). p.518-523
Abstract

Fatal intoxications with opioids are known to be associated with an increased lung weight, as well as with brain and pulmonary edema and urinary retention. However, there is evidence to suggest that fatal intoxications with non-opioid substances are also associated with increased lung weight; however, the latter aspect has not been comprehensively analyzed. To determine to what extent opioid and non-opioid substances are associated with increased lung and brain weight, we studied these organs in cases where the cause of death was attributed to intoxication with a single agent. Using data from cases autopsied at the National Board of Forensic Medicine (NBFM) in Sweden from 2009 through 2019 where the cause of death was attributed to a... (More)

Fatal intoxications with opioids are known to be associated with an increased lung weight, as well as with brain and pulmonary edema and urinary retention. However, there is evidence to suggest that fatal intoxications with non-opioid substances are also associated with increased lung weight; however, the latter aspect has not been comprehensively analyzed. To determine to what extent opioid and non-opioid substances are associated with increased lung and brain weight, we studied these organs in cases where the cause of death was attributed to intoxication with a single agent. Using data from cases autopsied at the National Board of Forensic Medicine (NBFM) in Sweden from 2009 through 2019 where the cause of death was attributed to a single substance, we created models of combined lung weight and brain weight. The models used age and sex as predictors as well as nested varying effects for the specific intoxicant and category of intoxicant. Suicidal hanging with negative toxicology cases served as controls. The population majority was male among both intoxications (68%) and controls (83%). The most common single substance group was opioids. All tested substances were associated with heavier lungs than controls, with the largest effect in the opioid group. Our findings show that several substances are associated with increased lung weight and that among intoxication deaths there is no difference in expected brain weight between substances. Hence, heavy lungs, without a reasonable explanation, should prompt a broad toxicological screening.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Forensic Sciences
volume
68
issue
2
pages
518 - 523
publisher
Wiley-Blackwell
external identifiers
  • pmid:36572955
  • scopus:85145324192
ISSN
0022-1198
DOI
10.1111/1556-4029.15187
language
English
LU publication?
yes
additional info
© 2022 The Authors. Journal of Forensic Sciences published by Wiley Periodicals LLC on behalf of American Academy of Forensic Sciences.
id
1e530db1-d6b6-4ba4-be10-3dce4e3f7d9d
date added to LUP
2023-01-01 16:27:11
date last changed
2024-04-16 07:19:55
@article{1e530db1-d6b6-4ba4-be10-3dce4e3f7d9d,
  abstract     = {{<p>Fatal intoxications with opioids are known to be associated with an increased lung weight, as well as with brain and pulmonary edema and urinary retention. However, there is evidence to suggest that fatal intoxications with non-opioid substances are also associated with increased lung weight; however, the latter aspect has not been comprehensively analyzed. To determine to what extent opioid and non-opioid substances are associated with increased lung and brain weight, we studied these organs in cases where the cause of death was attributed to intoxication with a single agent. Using data from cases autopsied at the National Board of Forensic Medicine (NBFM) in Sweden from 2009 through 2019 where the cause of death was attributed to a single substance, we created models of combined lung weight and brain weight. The models used age and sex as predictors as well as nested varying effects for the specific intoxicant and category of intoxicant. Suicidal hanging with negative toxicology cases served as controls. The population majority was male among both intoxications (68%) and controls (83%). The most common single substance group was opioids. All tested substances were associated with heavier lungs than controls, with the largest effect in the opioid group. Our findings show that several substances are associated with increased lung weight and that among intoxication deaths there is no difference in expected brain weight between substances. Hence, heavy lungs, without a reasonable explanation, should prompt a broad toxicological screening.</p>}},
  author       = {{Beer, Torfinn and Eriksson, Anders and Wingren, Carl Johan}},
  issn         = {{0022-1198}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{518--523}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Forensic Sciences}},
  title        = {{Increased lung weight in fatal intoxications is not unique to opioid drugs}},
  url          = {{http://dx.doi.org/10.1111/1556-4029.15187}},
  doi          = {{10.1111/1556-4029.15187}},
  volume       = {{68}},
  year         = {{2023}},
}