DEMOGRAPHIC AND INJURY DISTRIBUTION PATTERNS IN FATAL FALLS FROM HEIGHT

Background: Falls from height are an important cause of fatal trauma in India, particularly among construction and unorganised labour cohorts. Precise autopsy-based characterisation of injury patterns is essential for informed prevention and occupational-safety planning. Aims & Objective: To describe the demographic characteristics, occupational distribution, height of fall, organ involvement, and independent predictors of mortality among fatal fall cases in Southern Rajasthan. Methods: This prospective autopsy-based cross-sectional study included 76 consecutive fatal cases of fall from height examined at the Department of Forensic Medicine, R.N.T. Medical College, Udaipur, between April 2024 and June 2025. Data on age, sex, occupation, height of fall and autopsy findings were collected using a structured proforma. Descriptive statistics and multivariate logistic regression (SPSS v26) were used to identify independent predictors of fatal outcome (p < 0.05). Results: Males comprised 82% of deaths (n = 62). Age distribution peaked at 46–60 years (26.32%) and 19–30 years (23.68%). Construction workers (47.37%) and labourers (35.53%) accounted for the majority. Falls >15 ft comprised 40.78% of deaths. Cranio-cerebral injury was present in 78.95% of cases. Multivariate analysis identified head injury (AOR 3.45; 95% CI 1.75–6.80; p < 0.001), chest injury (AOR 2.92; 95% CI 1.40–6.05; p = 0.004), pelvic injury (AOR 2.35; 95% CI 1.05–5.25; p = 0.038), spinal injury (AOR 2.90; 95% CI 1.10–7.64; p = 0.032), and fall height >20 ft (AOR 2.05; 95% CI 1.10–3.84; p = 0.022) as independent predictors of fatality. Conclusion: The study team observed that middle-aged male construction workers are highly represented among fatal falls. Head and thoraco-abdominal trauma and greater fall height independently predict mortality. Multidisciplinary preventive measures and enforcement of occupational safety standards are recommended.