The Drowning Index (DI) can help to distinguish death by drowning from other causes.
Parameters:
(1) weight of left and right lungs in grams
(2) weight of pleural fluid in grams
(3) weight of spleen in grams
drowning index =
= ((weight of lungs) + (weight of pleural fluid)) / (weight of spleen)
Interpretation:
• The higher the index the greater the risk that death occurred due to drowning.
• Sugimura et al used a DI >= 14.1 for patients recovered within 2 weeks of death.
• In Figure 1 the weight of the pleural effusion was significantly greater than for asphyxia or cardiac death, with > 100 grams seen in drowning. Lung weight alone showed considerable overlap between the different causes of death.
Limitations:
• The presence of splenomegaly would lower the ratio. The spleen weight tended to be higher in patients with a cardiac death.
Performance:
• Sugimura et al reported a sensitivity of 66% and specificity of 78%.
• Wardak et al found that the DI was neither sensitive (< 10%) for drowning nor specific (60-70%).
