Issues in the diagnosis of hypothermia: a comparison of two geographically separate populations.

A review of hypothermic deaths was undertaken using cases from the Charité University, Berlin, Germany and Forensic Science South Australia, Australia. There were 16 cases from Berlin (age range 38-96 years; average 68 years; M:F = 13:3) Wischnewski spots were present in all 16 cases (100%), skin discolouration in nine (56%), and acute pancreatitis and muscle haemorrhage in one case each (6%). There were 62 Australian cases (age range 30-89 years; average 67 years; M:F = 13:18). Wischnewski spots were present in 57 (92%), skin discolouration in seven (11%), vacuolization of renal cells in six (10%), and acute pancreatitis in one (2%). Reporting of the pathological findings in hypothermia may vary among jurisdictions influenced by the location and nature of these deaths and also by reliance on particular features to make the diagnosis. In addition, it is possible that the aetiology of these markers is quite complex and involves not only a significant reduction in core temperature, but the variable and poorly-understood interaction of a number of other factors.