Autopsy Study of Organ Weights in a Tertiary Care Centre in Kerala

Background : Organ weight and its morphometric parameters are one of the most important indicators of possible organ defects or diseases, therefore, many studies have evaluated the normal range of body and organ morphometric parameters, such as organ size, weight, and volume, in different ethnic groups all over the world. Weighing organs during Autopsy is not a mere physical exercise, but carries great medico legal significance. Methods: A retrospective study was conducted by the Department of Forensic medicine at Government TD Medical College Alappuzha from autopsy data collected between January 2013 and December 2018. A total of 1206 cases (936 males and 270 females) were included in the study on the basis of inclusion criteria and the findings were recorded in the pre-designed proforma and analyzed. Conclusions : The average age of patients was 46.81 (between the ages 18 and 98), males 46.68(between the ages 18 and 95) and females 47.23 (between the ages 18 and 98). In Males, the average weight of the brain was 1266.39g (between 700 and 1976g), right lung was 484.41g (between 110 and 1400g), left lung was 425.09g (between 83 and 1426g), Heart was 289.56g (between 112 and 732g), Liver in male was 1356.99g (between 116 and 2822g) , spleen in male was 107.79 (between 12 and 948g) , right kidney was 119.53g (between 16 and 270g) and left kidney in male was127.16 (between 46 and 886g). In females the average weight of the brain was 1140.11g (between 725 and 1620g), right lung was 346.05g (between 98 and 992g), left lung was 303.43g (between 22 and 760g), was 241.13g between (68 and 479g); Liver was 1171.78g (between 550 and 2880g); spleen was 100.16g (between 18 and 509g); right kidney was 101.91g (between 36 and 624g) and left kidney was 104.23g (between 20 and 234g). Keywords-Autopsy, Liver, Lung, Heart, Spleen, kidney, organ weight. Introduction Organ weight and its morphometric parameters are one of the most important indicators of possible organ defects or diseases.1Therefore, many studies have evaluated the normal range of body and organ morphometric parameters such as organ size, weight and volume in different ethnic groups all over the world.2 Weighing organs during Autopsy is not a mere physical exercise, but carries great medico legal significance.3 Organ weights are important benchmarks in disciplines like surgery , pharmacology and radiation medicine.4 Organomegaly is considered as a sign of disease and can only be established if the reference range of data for an internal organ is available. Identification of organomegaly helps identify risk factors for certain diseases like sudden cardiac death.5Organ weights also play a significant role in estimation of body weight and height and thereby establishment of identity of an individual.6Standard textbooks such as Gray’s Anatomy and Ludwig give normal reference weight of organs.7,8 But, most of these use Caucasoid population which might not correlate with Indian population. There is great variation in the organ weights amongst the various races in the world, just as there is in stature and appearance. Therefore, this study aimed to assess the reference range of values of various organs in the population of Kerala. Indian Journal of Forensic Medicine & Toxicology, April-June 2021, Vol. 15, No. 2 2717 Aims and Objectives ● To obtain a reference value for various organ weights in the population of Kerala ● To compare the organ weights amongst sexes in the various age groups Materials and Methods Source of Data This retrospective study is being conducted by the Department of Forensic medicine at Government TD Medical College Alappuzha. This study analyses data from January 2013 to December 2018. A total of 1206 cases (males and females were included in the study on the basis of inclusion criteria. The study was conducted after approval from IEC (50/2019 dated 20/06/2019). Inclusion Criteria All cases subjected for autopsy from Jan 2013 to Dec 2018 whose completed profile and data were known are included in this study. Exclusion Criteria Decomposed bodies Gross organ pathology People with congenital anomalies/ Manifest macroscopic disease or anomaly History of prolonged medical illness Procedure The data was collected from the post mortem records and standard protocol was maintained for collection of parameters. The weight of the naked body was taken using an electronic weighing machine. The height of the decedent is measured in centimeters using measuring tape in the supine position from head to heel. Standard autopsy protocol and procedures proposed by Ludwig was employed for organ removal. Organ weight measurements were made using an electronic weighing scale having accuracy of +0.1gm, after the removal of foreign tissues. Statistical Analysis The data was entered into Microsoft Excel work sheet and was analyzed using Statistical Package for Social Service SPSS software version 16. Descriptive statistics such as frequency, percentage, minimum, maximum, mean ±SD and range were used. Results and Discussion 1206 cases met with all criteria prescribed for the study during the period of January 2013 to December 2018. The data was obtained from the records stored in the department and the cross-sectional retrospective study conducted. ( All results in table form Table 1 & 2) The gender distribution of the study participants was that 936 were female (77.6%) and 270 (22.4%) were female. The age distribution was evenly distributed in the following manner: 18 -30 years263 (21.8%), 31-40 years 212 (17.6%), 41-50 years – 224 (18.6%), 51-60 years – 242 (20.1%), 61-70 years – 159 (13.2%), 71-80 years – 79 (6.6%), more than 80 years. The mean age of the study population was 46.81+/17.07. In females the mean age was 47.23+/-19.60(18-98) while in males it was 46.68+/-16.27 (18-95). The mean organ weight of Brain in males was 1266.39(1976-700) and in females was1140.11 (1620725). The mean organ weight of Right lung in males was 484.41(1400-110) and in females was 346.05 (99298). The mean organ weight of Left lung in males was 425.09(1426-83) and in females was 303.43(760-22). The mean organ weight of Heart in males was 289.56 (732-112) and in females was 241.13 (479-68). The mean organ weight of Liver in males was 1356.99(2822116) and in females was 1171.18 (2880-550). The mean organ weight of Spleen in males was 107.79(948-12) and in females was 100.16 (509-18). The mean organ weight of Right kidney in males was 119.53 (270-16) and in females was 101.91 (624-36). The mean organ weight of Left kidney in males was 127.16 (886-46) and in females was 104.23 (234-20). 2718 Indian Journal of Forensic Medicine & Toxicology, April-June 2021, Vol. 15, No. 2 Table 1 : ORGAN WEIGHT IN VARIOUS AGE GROUPS IN MALES Age group Variables Brain Right lung Left lung Heart Liver Spleen Right kidney Left kidney 18-30 (n=192) Mean 1306.73 443.27 396.02 262.05 1323.82 116.57 115.79 123.40 SD 126.36 167.09 141.97 54.91 328.73 51.25 28.44 27.62 Range 754 962 880 334 2334 310 254 200 31-40 (n=170) Mean 1271.19 452.34 400.52 278.78 1501.23 118.81 121.83 128.08 SD 133.48 174.15 151.73 63.93 353.22 65.19 29.36 29.90 Range 82