Review on Sensitivity and Specificity of Clinical Findings in Examination of Corpse in Comparison to Spectroscopy Tests in Diagnosis of Death due to Carbon Monoxide Poisoning.

Background and Carbon monoxide poisoning is one of the common causes of mortality in developing countries, during the cold months of winter. At the moment, the final diagnosis is based on positive test of spectrophotometry. Considering that there are not laboratory facilities available all the time for carrying out this test. Therefore, we decided to review sensitivity and specificity of clinical findings in examination of corpse in comparison to spectrophotometry test in diagnosis of death due to carbon monoxide poisoning. All corpses with suspicious history of carbon monoxide poisoning, which were referred to the anatomy hall of the Tehran Laboratory Diagnostic Center from Aban to Esfand month of 1395, were examined. A blood sample from all of these bodies was taken to examination and conducted spectrophotometric testing in the toxic laboratory. Other information needed for this study was extracted from physician’s examination and autopsy of body and interview with relatives. Information of the cases were extracted and written in the prepared forms by an experienced physician. Data analysis was done using version 21 SPSS software. 107 bodies of males and 31 bodies of females were investigated. 112 cases died from carbon monoxide poisoning, and in 26 cases the cause of death were apart from carbon monoxide poisoning. In the study of clinical findings, in 110 cases bright red color of the hypostasis, in 92 cases bright red color of the conjunctiva, in 91 cases bright red color of the oral mucosa, in 99 cases bright red color of the nail bed and in 135 cases bright red blood were seen. In 110 cases spectrophotometric tests were positive and in 28 cases tests results were negative. On the other hand, 95 cases had positive clinical findings and 36 cases had negative clinical findings. Considering to the sensitivity of 94% and the specificity of 100% of the findings of clinical examinations in people who died due to carbon monoxide poisoning, as well as the positive predictive value of 100% and the efficiency of 94% of these findings, it can be concluded that if a body with the history of carbon monoxide poisoning refers to the anatomy hall and after examination of the corpse in sufficient light by the experienced physician, bright red color of the hypostasis, the nail bed, the blood and the oral mucosa and conjunctiva are observed, diagnosis of the carbon monoxide poisoning is suggested