Retrospective Autopsy Based Study of Fatal Road Traffic Accidents in Fiji

Abstract

Objective: To describe the demographic profile and distribution of injuries from autopsy cases due to fatal Road Traffic Accidents (RTA) in Fiji.Methods: This is a retrospective autopsy based study consisting of 102 medico-legal autopsies performed by the Fiji Institute of Forensic Science, Fiji Police Force during the period of two calendar years from January 1st 2011 to December 31st 2012.Results: Out of the 1454 medico-legal autopsies performed during the study period, 102 (7%) were due to fatal RTA. There were 72 (70.5%) males and 30 (29.5%) female fatalities with an overall male and female ratio of 2.3:1 and the 30 to 44 years age group showed highest number of victims of 30 (29.4%). The months of October in 2011 and August in 2012 took the maximum toll of road traffic deaths of 9 (8.8%) and 12 (11.6%) respectively. The highest number within the road user group were the passengers of 53 (51.9%) followed by the pedestrians and drivers of 32 (31.2%) and 16 (15.6%) respectively. Human behavioural errors or factors by all the road users of 95 (93.1%) was the highest contributing factor and pre-hospital mortality was most common, particularly road traffic death atthe scene (51.9%) and those whilst en route to hospital (29.4%). Highest number of injuries were head injuries of 67 (65.7%), followed by multiple injuries of 57 (55.6%), thoracic injuries of 56 (54.9%), abdominal injuries of 31 (30.3%), vertebral injuries 21 (20.5%) and major vessel injuries of 12 (11.7%). The most common mechanism of death was haemorrhagic shock of 90 (88.2%) followed by asphyxia of 7 (6.8%), arrhythmias of 3 (2.9%) and finally septic shock of 2 (1.9%).Conclusion: This study emphasizes the need for better pre-hospital and hospital trauma management, improved traffic law enforcement, effective traffic related and health policy creation, and the establishment of a national traffic traumatic injury surveillance registry in Fiji.