Abstract
Background: Road traffic accidents (RTAs) are a major global public health problem causing significant mortality, disability, and hospitalization. India contributes substantially to global RTA deaths, with motorized two-wheelers accounting for the highest share. However, evidence on fatal injury patterns among two-wheeler victims in eastern India remains limited. Objectives: To assess fatal injury patterns and associated factors among victims of motorized two-wheeler RTAs. Methods: An autopsy-based cross-sectional study was conducted in the Department of Forensic Medicine and Toxicology of an Institute of National Importance in eastern India. All fatal motorized two-wheeler RTA victims undergoing medico-legal autopsy between January 2020 and June 2021 were included. Information was collected from relatives, police records, hospital documents, and autopsy findings using a structured proforma. Data were analyzed using SPSS version 26. Associations were tested using Chi-square test. Results: Of 437 medico-legal autopsies, 92 (21.1%) deaths were due to motorized two-wheeler RTAs. Most victims were aged 21–40 years (47.8%) and male (78%). National highways were the most common accident site (51.1%). Helmet use was low (25%). Head injury and its complications were the leading cause of death (70.6%). Helmet use was significantly associated with engine capacity (p=0.003), showing higher compliance among riders of above 150 cc vehicles. Engine capacity also showed a significant association with cause of death (p=0.002), with head injury predominating among 100–149 cc vehicles. Conclusion: Motorized two-wheeler fatalities remain a significant preventable public health concern. Strengthening enforcement of road safety regulations, promoting protective riding practices, and improving highway safety and trauma care systems are essential to reduce mortality and support evidence-based road safety policy.
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