Deaths on rail roads: a study from Colombo North Teaching Hospital, Sri Lanka

In Sri Lanka railway related deaths are reported throughout the year. Most accidental deaths occur due to negligent behaviour of pedestrians and drivers.  Fatal train impacts cause extensive visceral and musculoskeletal injuries due to the nature of the object as well as the amount of force transmitted during impact.  A study of this nature would help ascertain demographic details of victims, characteristics of the incident of fatal train crashes and recognize the injury profile.  An autopsy based retrospective study was done using postmortem reports of 10 years.  Seventy autopsy reports from Colombo North Teaching Hospital between July 2006 and July 2016 were analyzed. Data regarding demographic details of victim and incident, external and internal injury distribution, cause and manner of death as determined at autopsy were extracted. Majority of victims were males between 20-39 years (43.7%, n=32) of age and were married (64.3%, n=45). Most victims of accidents were trespassers 68.8% (n=33).  68.6% (n= 48) and 31.4% (n=22) respectively were due to accidents and suicide.  The highest number of fatalities 64.3% (n=45) were observed between 2 pm to 10 pm.  The number of external injuries were more in accidents than suicides.  The most common cause of death was multiple injuries. Majority of the deaths were accidental. Transections of neck, chest and traumatic amputations of extremities were common in suicides than accidents.