Forensic Evaluation of Hanging-Related Deaths from Crime Scene to Autopsy

Introduction: Hanging is among the top methods of suicide in the world, and it contributes to a significant proportion of global mortality. It represents an expert forensic puzzle, needing meticulous plotting to disentangle suicides from homicides from accidental deaths. The purpose of this study is to evaluate the forensic characteristics of hanging-related fatalities, to generate demographic and postmortem data, and to assist in a more accurate classification of causes of death to optimize preventive measures in the future. Methods: The study population involved 50 suspected hanging cases. Data were collected from the Department of Forensic Medicine and Toxicology at Rajshahi medical college, Rajshahi, Bangladesh over 12 months from February 2024 until March 2025, concentrating on cases of hanging deaths. Data were retrieved from case files, including demographic details, crime scene investigation reports submitted by investigating officer as inquest report of respective autopsy cases, and autopsy findings. Descriptive statistics were used to recapitulate demographic data, crime scene findings, and autopsy results. Results: The most presented cases (76%) were male and of mean age 20–40 years (56%). Private homes accounted for the most deaths (64 %), with outdoor locations (20 %) and prisons (16 %) trailing behind. Fifty percent of ligature material was rope, (70%) was fixed knots, and (84%) was complete suspension. Patients were diagnosed in a median period of 5.1 days, and significant postmortem findings were horizontal ligature marks (60.0%) and low incidence of skeletal fractures (30.0%). Toxicology was positive for significant alcohol (40%) and sedative use (24%). Suicide was the most common manner of death (84 percent), followed by accidental deaths (10 percent) and homicides (6 percent). Conclusion: The results of this study underlines the need for a multifaceted forensic study of individuals who die from hanging. This information can improve the classification of the manner of death while also offering valuable information on how to prevent suicides by correlating data found from crime scene data, ligature materials, and autopsy findings. The findings highlight the need for improved mental health care and tailored intervention programs among persons at risk, particularly young to middle-aged males. More research is needed on the environmental and psychological factors influencing these deaths.