Pattern of Medico-Legal Autopsies and Causes of Death in a Tertiary Care Hospital: A Retrospective Analysis

Background: Medico-legal autopsy is the cornerstone of medico-legal practice and remains the most important method to determine the cause and manner of death in unnatural or suspicious deaths. The pattern of such deaths varies with geography, socio-economic profile and the catchment area of the hospital. Objectives: To analyse the demographic profile, manner and cause of death among medico-legal autopsies conducted at a tertiary care teaching hospital in central India over a five-year period. Materials and Methods: This retrospective, record-based observational study was conducted in the Department of Forensic Medicine and Toxicology, Bharat Ratna Late Shri Atal Bihari Vajpayee Memorial Government Medical College, Rajnandgaon, Chhattisgarh. All medico-legal autopsies performed between 1 January 2021 and 31 December 2025 were included. Autopsy registers, inquest papers and post-mortem reports were reviewed. Data were coded in Microsoft Excel and analysed with descriptive statistics; categorical variables are expressed as frequencies and percentages. Results: A total of 3250 medico-legal autopsies were performed during the study period, with a progressive year-on-year rise from 400 cases in 2021 to 900 cases in 2025. Males (72.0%) outnumbered females (28.0%) with a male-to-female ratio of 2.57: 1. The most affected age group was 21-30 years (28.5%), followed by 31-40 years (22.0%). Accidental deaths accounted for the largest share (55.0%) of all autopsies, followed by suicidal (20.0%), natural (15.0%), homicidal (7.0%) and undetermined (3.0%) deaths. Road traffic accidents emerged as the single leading cause of death (30.0%), followed by poisoning and natural causes (15.0% each), hanging (12.0%) and burns (8.0%). A rural predominance (65.0%) was observed. Conclusion: Road traffic accidents, poisoning and hanging constitute the top three preventable causes of medico-legal mortality in the region. Young adult males constituted the largest demographic group in this autopsy series. Strict enforcement of traffic laws, strengthening of mental-health services and regulation of pesticide access are urgently warranted.