Unexplained Deaths Evaluation of Clinical Features, Autopsy Findings, Toxicological Results and Forensic Investigation

Abstract

Background: Unexplained deaths require systematic integration of clinical, autopsy, toxicological, and forensic evidence to establish the cause and manner of death. Objective: To evaluate unexplained deaths by assessing clinical features, autopsy findings, toxicological results, and forensic investigative evidence and their contribution to determining the cause and manner of death. Methodology: A retrospective observational study was conducted from April 2025 to March 2026. Consecutive unexplained-death cases were evaluated using clinical records, circumstantial information, autopsy examination, histopathology, toxicology, and forensic investigative reports. Data were analyzed using SPSS version 26.0. Results: Among 250 cases, 174 (69.60%) were male and 76 (30.40%) female. Sudden collapse was reported in 89 (35.60%) cases, while 137 (54.80%) had no documented preceding symptoms. Pulmonary congestion/edema was identified in 81 (32.40%) cases, whereas 74 (29.60%) showed no significant gross abnormality. Toxicology was negative in 168 (67.20%) cases. Cardiovascular disease was the leading cause of death in 58 (23.20%), while no definitive cause was established in 35 (14.00%). Natural deaths accounted for 112 (44.80%) cases. Conclusion: Multidisciplinary assessment combining autopsy, histopathology, toxicology, clinical records, and forensic investigation is essential for improving diagnostic certainty in unexplained deaths.