Intérêt de l’expertise toxicologique en médico-légale post-mortem : expérience du service de toxicologie chu Sétif

Abstract

Introduction: A toxicological expertise is often requested in order to explain death, even if it sometimes fails to establish the cause of death. Objectif: The aim of this study is to demonstrate the importance of toxicological analysis in the medicolegal context. Material and Methods: Retrospective study over a four-year period (2019-2022) of autopsy reports, performed in the CHUS toxicology laboratory on autopsy specimens. Results: A total of 949 forensic autopsy cases were subjected to toxicological analysis, with males representing the predominant sex (73.3%). The average age was 39, with the highest number of cases in the 18-50 age bracket (59.5%). A total of 275 (29%) cases gave positive toxicological results. Alcohol was the most common substance found, accounting for 50.5% (139 out of 275 positive cases), followed by pharmaceuticals 26.5% (73 cases), HbCO 26.2% (72 cases), drugs of abuse 11.3% (31 cases) and, lastly, carbamate pesticides, with only 2 positive cases. Benzodiazepines were the most frequently encountered pharmaceutical drug class (32.9%, N=82), ahead of phenobarbital and carbamazepine (18.3%). Cannabis tops the list of illicit drugs with a prevalence of 77.1% (out of 35 positive results), while the remaining 22.9% of these drugs are divided between amphetamines, opiates and ecstasy, with no cases of cocaine. Combinations of two or more types of substance accounted for 14.9% of positive cases (n=41, N=275), three-quarters (75.6%) of which included alcohol (n=31). Conclusion: Forensic toxicological analysis, in addition to autopsy, is an important element of the forensic file.