Comparison of forensic cases admitted to the emergency department after the 6 February 2023 Kahramanmaraş earthquake with the pre-earthquake period

OBJECTIVE: Disasters are major events that impact the demographic structure, population distribution, and psychological and physical characteristics of societies. Among natural disasters, earthquakes are the most devastating, causing the greatest destruction. In this study, we investigated the effect of earthquakes on forensic cases in society by evaluating forensic cases admitted to the emergency department. MATERIALS AND METHODS: This study was conducted retrospectively by analyzing and comparing forensic cases admitted to the Emergency Department of Adıyaman Training and Research Hospital six months before and six months after the earthquake on February 6, 2023, following approval from the Adıyaman University Ethics Committee. Data on admitted patients were obtained from the hospital system and initially categorized based on all forensic cases, including gender, age, time of admission, type of forensic case, type of insurance, mode of transport to the emergency department, and distribution of hospitalizations across different departments. Forensic cases were further categorized into subgroups such as traffic accidents, occupational accidents, and poisonings, and a detailed comparison was made between the pre- and post-earthquake periods. Statistical analysis was performed using SPSS v. 17.0, and a p-value of <0.05 was considered statistically significant. RESULTS: A total of 8,247 forensic cases met the inclusion criteria, with 4,978 cases in the pre-earthquake period and 3,269 cases in the post-earthquake period. In both periods, the majority of forensic cases involved male patients. However, the proportion of female cases was significantly higher in the post-earthquake period (21.8%) compared to the pre-earthquake period (17.5%) (P<0.001). The mean age of forensic cases was 33.23±12.92 years in the pre-earthquake period and 35.48±13.5 years in the post-earthquake period (P<0.001). Among forensic case types, in the pre-earthquake period, detainee forensic examinations (38.2%) were the most common reason for admission. However, in the post-earthquake period, the most frequently reported forensic cases were traffic accidents (27.4%) and assault cases (27.4%), and this change was statistically significant (P<0.001). When examining the time of admission, cases presenting between 08:00-16:00 increased significantly in the post-earthquake period compared to the pre-earthquake period (42.4% vs. 33.6%) (P<0.001). Intensive care unit admissions decreased significantly after the earthquake, whereas internal medicine and thoracic surgery ward admissions showed a statistically significant increase (p<0.001). Among poisoning cases, the proportion of patients with a history of psychiatric illness in suicide-related poisonings decreased significantly in the post-earthquake period (12.2%) compared to the pre-earthquake period (34.7%) (p<0.001). In hospital-admitted traffic accident cases, the proportion of male patients significantly increased in the post-earthquake period (87.8%) compared to the pre-earthquake period (74.%) (p=0.018). Thoracic injuries due to traffic accidents increased significantly in the post-earthquake period (33.3%) compared to the pre-earthquake period (14.2%) (p<0.001). When comparing hospitalizations due to traffic accidents, admissions to thoracic surgery and intensive care units significantly increased in the post-earthquake period (p=0.006). Regarding occupational accidents, the most common sectors affected in the pre-earthquake period were factories (43%), construction (38%), small businesses (12.4%), and public employees (5.6%). In the post-earthquake period, the ranking changed to construction (42%), factories (33.2%), small businesses (12.7%), and public employees (11.5%). Occupational accidents in the construction and public sectors significantly increased after the earthquake (P=0.010). CONCLUSION: Our study demonstrates that disasters alter the distribution of forensic cases. Due to the disruption of public order following disasters, traffic accidents, occupational accidents, and assault cases have increased. Among poisoning cases, suicide-related poisonings have increased among patients with no prior history of psychiatric illness. Therefore, the rapid restoration of public order and a return to normal life following disasters is crucial. Based on the observed changes after the earthquake, societies and governments must be prepared for disasters before they occur. If preventive measures are insufficient before the disaster, actions taken afterward may not be adequate to restore lost lives, disrupted living conditions, and deteriorated mental health.