Spatiodemographic Clustering and Determinants of Fatal Road Traffic Injuries at Thana Level

Abstract Background: Road traffic injuries (RTIs) are still a major cause of preventable mortality, especially in growing urbanised areas of low- and middle-income countries. There is little information on the application of spatial clustering and micro-level (thana-level) analysis in association with autopsy results on zones of high risk and factors contributing to fatal outcomes. Aim: The aim of the study was to analyse the multi-level spatiodemographic clustering and identify the predictive determinants of fatal RTIs using autopsy. Materials and Methods: A retrospective observational study was conducted on 10,617 medico-legal autopsy cases at King George’s Medical University, Lucknow. Data were analysed for age, gender, zone and thana-wise distribution. Statistical analysis included descriptive statistics, Chi-square test and logistic regression to identify significant associations and predictors. Results: A strong male predominance (84.2%) was observed, with the majority of cases occurring in the 18–45 years age group (~60%). Spatial analysis revealed significant clustering in the West Zone (66.9%), identified as the primary high-risk area. Thana-wise distribution showed an apparent dominance of Chowk (57.06%), which was attributed to medico-legal referral bias due to its jurisdiction over the tertiary care centre. Other thanas such as Gomti Nagar and Wazirganj represented actual high-risk zones. Chi-square analysis showed a significant association of age with zone ( P < 0.01), while regression identified West Zone (odds ratio = 3.82) as the strongest predictor. Conclusion: RTA fatalities demonstrate a structured spatiodemographic pattern driven primarily by environmental exposure, with demographic factors acting as modifiers. Recognition of referral bias and micro-spatial clustering is essential for accurate interpretation and targeted intervention.