Estimating antemortem drug concentrations from postmortem blood samples: the influence of postmortem redistribution

Aims-To compare blood drug concentrations during life with postmortem drug concentrations measured from a peripheral site and a central site. Methods-Coroner's cases from October 1990 to July 1997 were reviewed. Six c ases had data on both antemortem and postmortem blood drug concentrations. The postmortem to antemortem ratio was compared with the postmortem central to peripheral ratio, using cardiac blood as a central site and femoral blo od as a peripheral site. Results-Drugs that have a high postmortem central to peripheral ratio; that is, drugs that exhibit considerable postmortem redistribution, also have h igh postmortem to antemortem ratios. Conclusions-A large degree of error can arise from attempting to estimate a ntemortem drug concentrations and the ingested dose from postmortem measure ments. The chosen site and technique for postmortem blood sampling can grea tly influence the concentration of drug measured.