Clinical and autopsy findings of the homeless

Abstract

Introduction/Objective The population of homeless people has been growing rapidly over the past decades, and is a part of regular repertoire in daily autopsy practice. The paper aims to establish a contingent of autopsy findings specific for homeless persons using a cohort approach.

Methods The study group consisted of the bodies of 37 homeless men autopsied in the past 15 years. The control group consisted of 37 men and was created by a driven randomized selection following the same distribution of the causes of death. A standardized full autopsy was performed in every case, followed by microscopic examination and toxicology if indicated. Many external and internal features were compared.

Results Homeless people lived significantly shorter, and were more often unidentified at the time of autopsy (p < 0.05). As for external features, we found that homeless people were significantly shorter, with longer hair, beard, and nails, and worse dental status compared to the control group (p < 0.01); 70.3% of the homeless people were underweight; significantly more often suffered from infectious lung diseases, alcoholic liver disease and showed signs of old brain contusions (p < 0.01); they had higher blood alcohol concentrations at the time of death compared to the controls (p < 0.05), but a significantly lower atherosclerotic grade (p < 0.01), and were found to die significantly more often during the winter months (p < 0.01). Besides this, the homeless are more usually affected by specific and non-specific lung inflammations and alcohol liver diseases.

Conclusion Autopsy findings of homeless people define an almost particular presentation compared with controls.

Keywords: homeless; autopsy; tuberculosis; alcohol liver disease