Determinants of Inconclusive Medicolegal Autopsies in Northern Bangladesh: A Four-Year Retrospective Analysis at a Tertiary Medical College

Abstract Background: The autopsy is crucial for determining the cause and manner of death in medicolegal cases. However, a subset of autopsies remains inconclusive. Objective: This study aimed to determine the rate and analyze the determinants of inconclusive autopsies at the mortuary of Dinajpur Medical College, Dinajpur. Methods: A retrospective, record-based descriptive study was conducted analyzing all autopsy cases from October 2021 to September 2025. Data were extracted from mortuary records on demographic variables, year of autopsy, body condition, geographic origin, and time delay before autopsy. Descriptive statistics were used to analyze the data. Results: Out of 1069 autopsies performed, 77 were inconclusive, yielding a rate of 7.20%. A concerning surge was observed, with the inconclusive rate rising to 10.42% in 2024. The majority of inconclusive cases were male (63.64%) and belonged to the 31-40 age group (27.27%). The condition of the body was a critical factor, with "decomposed" (42.86%). The mean time delay between body dispatch and autopsy was 15 hours and 24 minutes, with a wide range (1 hour to 28 hours). Most cases were referred from Dinajpur Sadar upazila (41.56%). Conclusion: The study reveals a high and escalating rate of inconclusive autopsies, strongly associated with the condition of the body upon receipt and logistical delays.