Original ArticlesAutopsy-Diagnosed Injury Deaths in Persons With Acute or Chronic Alcohol Use A Review of 1000 Deaths With History of Alcohol UseStahl-Herz, Jay MD; Pasquale-Styles, Melissa MD Author Information From the Office of Chief Medical Examiner, City of New York, New York, NY. Manuscript received October 25, 2021; accepted March 16, 2022. The authors report no conflict of interest. Reprints: Melissa Pasquale-Styles, MD, New York City Office of Chief Medical Examiner, 421 E 26th St, New York, NY 10016. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology 43(4):p 334-339, December 2022. | DOI: 10.1097/PAF.0000000000000765 Buy Metrics Abstract Acute and chronic alcohol use is associated with injury, and autopsies may be performed to ascertain injury deaths in persons with acute or chronic alcohol use. This study sought to determine how many decedents with a history of acute or chronic alcohol use had an internal physical injury diagnosed only at autopsy that caused or contributed to the death. The study reviewed medicolegal investigation and autopsy reports at the New York City Office of Chief Medical Examiner between January 1 and October 11, 2018, to identify 1000 consecutive persons with suspected acute or chronic alcohol use who were autopsied to ascertain whether internal physical injury caused or contributed to the death. Of 1000 persons with known or suspected acute or chronic alcohol use, 390 (39.0%) had an external injury. Although 115 (11.5%) had an internal injury at autopsy, only 29 (2.9%) had an injury that caused or contributed to the death. Only 1 decedent had an internal injury that caused the death with no associated external evidence of injury (0.1%). This study demonstrates the rarity of occult lethal injury diagnosed at autopsy in persons with acute or chronic alcohol use. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.