ArticleIrish journal of medical science2026
Toward a risk-based autopsy framework: identifying pre-autopsy predictors of illicit substance use.
Article in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEarly recognition of substance use risk through contextual and behavioral indicators at first encounter is essential for guiding subsequent forensic procedures and safety measures.
aimTo identify sociodemographic and external physical indicators that predict toxicologically confirmed illicit substance use in postmortem cases, aiming to inform structured risk-based triage models that enhance toxicological decision-making and occupational safety.
methodsA retrospective case series was analyzed at a high-volume metropolitan forensic autopsy unit. Cases were systematically reviewed and coded using a dedicated forensic database to evaluate demographic factors, external examination findings, and toxicology outcomes.
resultsIllicit substance use was significantly associated with male sex, young adult age, injection marks, self-inflicted scars, and tattoos with criminological or substance-related themes. Although cachexia appeared more common among substance-positive individuals, the association was not statistically significant. The absence of key sociodemographic data (e.g., occupation, education) was noted as both a limitation and a potential indirect indicator of marginalization.
conclusionsSeveral pre-autopsy indicators may support the early identification of individuals at elevated risk for illicit substance use, enabling more focused toxicological screening and stronger biosafety precautions. In routine forensic practice, where background data are often missing, and such absence may itself reflect elevated risk, a structured, observation-based triage approach can improve both diagnostic yield and occupational protection.
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