Post‌-Mortem Serum level of Cortisol and its Relation with the Cause, the Time, and circumstances of Death: A Cross-sectional Cadaveric Study

Introduction: Cortisol is one of the stress markers in addition to catecholamine and other chemicals. Aim of the study: to measure the postmortem level of cortisol in people who died after various traumatic injuries to find its relationship with the date of death, cause of death, and circumstances surrounding death Patients and methods: This is a cross-sectional study included 50 cadavers, 33 males and 17 females (mean age 32.28 years).  Samples of blood were collected and submitted to chemical analysis to measure the level of serum cortisol. ELISA. Was applied, which is based on the competitive interaction of cortisol and the hormone; the amount of bound hormone-enzyme conjugate is inversely proportional to the concentration of cortisol in the specimen, a blue color develops changing to yellow after stopping the reaction, the intensity of the color is inversely proportional to the amount of cortisol in the specimen. The absorbance was measured by spectrophotometry at 450 nm wavelength as soon as possible or within 30 min. Another sample of 50 living patients was included as a control for the level of cortisol. Results: The study showed that there is statistically significant mean difference (p-value = 0.0002) in cortisol levels between live and dead persons. There were no statistically significant differences in cortisol levels between males and females, as well as various age groups. The highest level of cortisol was recorded in patients who died suddenly followed by a gunshot. The highest level was recorded after 24 hours. The highest level was recorded in patients who died due to chest injury followed by head injury. Conclusion: Cortisol level in blood is significantly higher in dead persons compared to its level in living; this might be explained by the stressful agonal period before death, Cortisol levels did not show a positive correlation with time after death, however, it showed abrupt rise after the first 12 hours after death which continue after 38hours, This may be explained by the beginning of decomposition. There is a strong correlation between the postmortem level of cortisol and the cause of death; being high in sudden death, and firearm injuries, Cortisol levels are significantly higher in chest injuries compared to other regions of the body. Recommendation: Based on the study, the following recommendations are suggested: Ongoing research about post-to-mortem serum level of Cortisol Causes and circumstances of death.