Date Published: April 18, 2018
Author(s): Lumamba Mubbunu, Kasonde Bowa, Volodymyer Petrenko, Moono Silitongo.
The objective of the research was to study the correlation of internal organ weights with body weight and length in normal adult Zambians. The study involved 114 (83 males and 31 females) forensic autopsies from Ndola Teaching Hospital done over a period of 12 months. The cases included autopsies of unnatural deaths including road traffic accidents and homicide. Cases where information about age and origin of the person was not available were left out of the study. The age of the decedents ranged from 16 to 85 years. The data was analyzed by Pearson correlation coefficient to determine correlation. P values less than 0.05 were considered to be statistically significant. It was observed that the heart, liver, left kidney, right kidney, brain, and left lung were positively correlated to body weight, while only the brain and the left lung were positively correlated to the height in the male population. In the female population, the heart, liver, right kidney, brain, and right lung were positively correlated to the weight of the body, while only the right kidney was positively correlated to the height of the body.
The weight of internal organs is important in forensic medicine and pathology, because the weight of internal organs is useful in determining whether the organ is normal or pathological. Many diseases have been shown to change the weight of internal organs [1, 2]. The change in the weight of an internal organ can be used in interpreting the opinion regarding the cause of death during an autopsy. Changes in the weight of an internal organ may be the only evidence to show that an organ is not normal. For example, the elevated weight of the heart may be the only evidence to myocardial hypertrophy that is often macroscopically and microscopically difficult to recognize . In a similar vein, in a study by Greaves in 2000 , he reported that changes in kidney weight may also reflect renal toxicity, tubular hypertrophy, or chronic progressive nephropathy. In forensic pathology as well as in clinical medicine any deviation from the normal weight of an internal organ would be indicative of a pathology to that organ or a compensatory mechanism in response to applied stress to an organ. For example, if there is increased pulmonary resistance, the right ventricle of the heart may enlarge in response to the increase in the pressure required to pump blood through the pulmonary circulation . The increase in the weight of an internal organ can only be determined if there is a reference weight, in this case the recorded weight of that internal organ to which the weight of an internal organ can be compared to. Since the determination of the normal weight of an internal organ is based on comparison with the reference data, the reference data should as much as possible be representative and be as accurate as can be to show that the reference weight shows the normal value . The weight of internal organs can be a good diagnostic criteria for interpreting autopsy information if the weights of internal organs are compared to the appropriate reference weights [7, 8]. This means that normality for the weight of internal organs in a given population should be accurately defined. One of the ways to define this data is to generate reference tables for that population, meaning the average weight to be used as reference information should be generated from the people of that population. Another method that can be used to normalize the information is correlation of internal organ weights to body length and body weight. As it stands Zambian pathologists use references from American or European textbooks. The problem with these sources of information is that they may not be suitable for the Zambian population when interpreting postmortem cases. This could lead to inaccurate interpretation of postmortem cases. Human internal organ weights not only are determined by race, age, or gender but are also anticipated to be dependent on environmental and social economic conditions which may be quite different in various parts of the world. Hence, the weights of organs reported from other countries may not be the same as that for Zambian population. The current work was undertaken to study the average weight of Zambian population and correlate the weight of internal organs with body weight and height.
The study was undertaken at Ndola Teaching Hospital mortuary. The organs were weighed from selected bodies that satisfied the criteria for inclusion in the study. The bodies were selected from postmortem cases brought to the pathologists for forensic investigations for a period of 12 months. During this period, 114 cases were sampled, and all the autopsies that were used in the study were done by the same pathologist and anatomist. In the study, subjects who died due to natural causes were not included; this was because the organs in patients succumbing to a variety of morbid anatomical lesions or disease process were considered to be pathological. The assumption was that the ideal subjects for establishing the weight of internal organs would for those dying from accidental and violent deaths . The assumption is that decedents who die accidentally are healthy. For the purposes of this study, normal organ was defined as an organ from a person who did not have any evidence of any type of disease or infection that would damage that organ: the gross appearance of the organs had to be without any evidence of any type of damage and or pathology.
The height was measured from head to heel using a height measure in centimeters. The body was weighed naked [6, 7]. Using a scale 0.0 Kg to 300 kg with accuracy of ±100 g, the scale was calibrated by the Zambia weight and measure agency and 0.5, 1.0, and 5.0 Kg control weights were used to calibrate the scale every time before it was used. The internal organs were weighed using a calibrated electronic balance 0.0 g to 5000 g with accuracy of ±0.1 g. The collected data was analyzed using IBM-SPSS program version 23. They were divided into gender: male and female. Person’s correlation coefficient was used to analyze the relationships between body weight and body length of the internal organs at P < 0.05. The sample population for this study was made up of people who had died in road traffic accidents and homicide cases that were brought to Ndola Teaching Hospital for autopsy. 114 cases were selected for the study: 31 females and 83 males. The age group for the females was 18–85 years with the average age of 39.9 ± 15.2 years, while that of the males was 16–85 years with an average of 38.1 ± 16.0 years (see Table 1). The weight and height of the decedents were also measured, and the average weight and height for the female population were 57.5 ± 11.2 Kg and 163.4 ± 6.7 cm, respectively, while those of the male population were 58.5 ± 11.2 Kg and 169.2 ± 7.84 cm (See Table 1). 90% of the samples decedents deaths were road traffic accidents and 10% suspected murder cases. In this study, it was observed that the heart, liver, left kidney, right kidney, brain, and left lung were positively correlated to body weight, while only the brain and the left lung were positively correlated to the height in the male population. In the female population, the heart, liver, right kidney, brain, and right lung were positively correlated to the weight of the body, while only the right kidney was positively correlated to the height of the body. Further work is required with a larger sample population to ascertain the true relationships of the weight of internal organ with body weight and height. Further work will need to be done in this area with a large population of at least 2000 subjects to improve the statistical validity of the arguments. All regions of Zambia will have to be covered not just one center like Ndola central hospital in this case. Multiple centers and increased period of study may increase the sample size. Source: http://doi.org/10.1155/2018/4687538