Fatal suffocation: A 7-year autopsy study in Lagos, Nigeria

Suffocation is a major class of asphyxial deaths encountered in forensic post-mortem examinations. Several studies have described the patterns of different types of suffocation deaths but there is a paucity of studies and autopsy findings of suffocation in the Nigerian environment. This study is aimed at determining the prevalence and pathological features of suffocation-related deaths at autopsy as seen in the Chief Medical Examiner’s Office in Lagos State, Nigeria. This is a 7-year autopsy-based study of suffocation deaths between 1 st January 2008 and 31st December 2014. Demographic data and morphologic features of asphyxia were retrieved from autopsy reports, case notes, and extracts from Coroners’ request forms submitted by the Police. The results were analysed using SPSS Version 20. Suffocation deaths accounted for 57(24.8%) of all asphyxial deaths and 0.77% of all autopsies done over the study period. The peak age group of suffocation death was 31–40 years with a male to female ratio of 2:1. Most (89.47%) of suffocation cases were due to aspiration of stomach contents. Hyperaemia of the airways, petechial haemorrhages and pulmonary oedema were the most common morphologic features seen. This study showed that almost all suffocation deaths were due to gastric aspiration mostly secondary to delayed medical intervention. Most of the decedents were in the 4th decade of life with a male preponderance. One case of homicidal suffocation due to combined smothering and choking was observed.