Trauma is one of the most common causes of death all over the world. The concept of trauma is very heterogeneous, due to its causes, types of injuries, severity, individual genetic variations and pathophysiological variability. This review explores the influence of these factors on trauma response and their forensic implications.
This work synthesizes and analyzes scientific literature on the influence of genetic factors on the response of fatal traumatic injuries, concerning the interplay between genetics, trauma pathophysiology, and forensic interpretation. Trauma mechanisms include blunt, sharp, penetrating, and combined forces, each producing distinctive injury patterns. Pathophysiological aspects such as inflammatory response, haemorrhagic shock, multiple organ dysfunction syndrome, and the influence of pre-existing diseases contribute to the complexity in the forensic analysis of trauma-related deaths. Cases where trauma interacts with pre-existing disease such as coronary artery disease, aneurysms, pulmonary embolism, or genetic disorders like osteogenesis imperfecta are also medico-legal relevant. Genetic variability modulates individual response to trauma, influencing outcomes such as recovery, disability or death. Single nucleotide polymorphisms in genes such as APOE, IL-1, IL-6, TNF?, COMT, BDNF, NOS3, and ACE have an influence in traumatic brain injury response.
Recognising genetic and physiological variability enhances forensic interpretation of trauma-related deaths, improves accuracy in cause-of-death determination, and clarifies medico-legal accountability. Although most research focuses on traumatic brain injury (TBI), expanding investigations to other trauma types is essential.