Cortisol is the major glucocorticoid mediating the body As stress reaction to physical and psychological strains; this stress response is generally regarded as a helpful survival mechanism. Cortisol secretion can increase within minutes in acute stress situations, and can stay at high levels for long periods, days or months, in chronic disease conditions. Cortisol levels in blood, serum, and urine are heavily increased (10-20 times) in critically ill patients, e.g., those with sepsis or other life-threatening diseases . Thus, cortisol production increases in stressful conditions leading to death, which is reflected as increased urinary excretion of cortisol, and high urinary cortisol concentration is expected in many postmortem cases. The main purpose of the present study was to investigate whether the measured urinary cortisol value could suggest certain types of deaths, which might be of value in investigating unclear postmortem cases. The high median values observed in the infection and ketoacidosis subgroups were in accordance with the relatively long and physically stressful course leading to death in these types of cases. Lower levels might be expected in cases with a presumably more rapid course e.g., asphyxiation and fire-related deaths as was also revealed as a trend in the present data. The poisoning subgroup displayed a very wide range of values, possibly reflecting the spectrum from rapid to delayed intoxication deaths.
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Last date updated on January, 2021