Our previous studies demonstrated the usefulness of screening determinations of acetone as an initial diagnostic criterion in deaths due to hypothermia, alcoholic ketoacidosis, diabetes mellitus, starvation and some poisonings. In alcoholemia, particularly in cases of prolonged ethanol consumption, the above-mentioned conditions may not result in acetonemia, despite marked concentrations of beta-hydroxybutyrate acid (beta-HBA). Therefore, for the purpose of the present study, the method of beta-HBA determination was modified using GC-MS-EI and applied to analyze 47 autopsy blood samples of individuals who died suddenly due to unknown causes. In 15 cases, the concentration of beta-HBA was higher than 1000 micromol/l; in six subjects from this group, the acetone concentration was lower than 250 micromol/l. In some cases, thus, the use of beta-HBA as an additional diagnostic criterion allows for explaining the pathomechanism of premortal metabolic disturbances.
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