@article{ref1,
title="The Drowning Index: implementation in drowning, mechanical asphyxia, and acute myocardial infarct cases",
journal="Journal of forensic sciences",
year="2014",
author="Wardak, Khalil S. and Buchsbaum, Robert M. and Walyzada, Frozan",
volume="59",
number="2",
pages="399-403",
abstract="Drowning is a diagnosis of exclusion based on circumstantial and autopsy correlation. Sugimura proposed a threshold value of 14.1 for the Drowning Index (DI), the ratio of lung and pleural fluid to spleen weight, as a surrogate marker to diagnose drowning. We questioned the use of DI in diagnosing drowning. We compared DI between three groups-drowning, mechanical asphyxia, and myocardial infarct-seen at Broward MEO from 2008 to 2009. Only 9.4% of 53 drownings exceeded the DI threshold of 14.1, while 30% of 10 mechanical asphyxias and 40% of 10 myocardial infarcts had DI >14.1. Sensitivity for the DI test was <10% and specificity 60-70%. Median DI values for all groups were <10. Mann-Whitney U-test was not statistically significant between groups. The DI is neither sensitive nor specific and lacks any utility in the diagnosis of drowning.<p /> <p>Language: en</p>",
language="en",
issn="0022-1198",
doi="10.1111/1556-4029.12356",
url="http://dx.doi.org/10.1111/1556-4029.12356"
}