Demographic and Clinical Spectrum of Forensic Cases in the Emergency Department: A Retrospective Analysis of 25 887 Presentations

Abstract

Background: This study aims to evaluate the demographic and temporal characteristics of forensic presentations involving physical or psychological harm, negligence, or intentional injury and to analyze the specific factors influencing mortality among these presentations. Methods: This single-center, retrospective, cross-sectional study was conducted on forensic presentations presenting to the emergency department. Demographic data, injury mechanisms, seasonal variations, and clinical outcomes were evaluated. Data retrieved from the hospital’s electronic health record system were analyzed statistically. Multivariable logistic regression analysis was performed to identify independent predictors of mortality. Results: A total of 25887 presentations were included in the study. Of the participants, 79.8% were adults and 68.9% were male, with a mean age of 34.0 ± 18.8 years. Motor vehicle accidents (21.0%) and falls from height (17.2%) were the most common injury mechanisms. Forensic presentations peaked in August (11.1%). While discharge rates were significantly higher in adults (61.9% vs. 41.3%; P < .001), mortality was significantly higher in pediatrics (2.1% vs. 1.2%; P < .001). Multivariable regression analysis identified firearm injuries (adjusted odds ratio = 7.12) as the mechanism most strongly associated with mortality in the adjusted model of mortality. Conclusion: Forensic presentations to the emergency department showed a significant concentration among young adult males and during the summer months. Although motor vehicle accidents and falls from height were the most frequent etiologies, multivariable analysis identified firearm injuries as the mechanism most strongly associated with mortality in the adjusted model of mortality. These findings suggest that the findings may help inform triage and resource-planning studies for high-risk injury mechanisms and pediatric populations. Furthermore, healthcare facilities should implement strategic resource and personnel planning to account for the seasonal surges in forensic presentations. Cite this article as: Tortum F, Tekin E, Kök AN. Demographic and clinical spectrum of forensic cases in the emergency department: a retrospective analysis of 25 887 patients. Eurasian J Med. 2026, 58(4), 1626, doi: 10.5152/eurasianjmed.2026.261626.