Death by fall. Remarks about 443 necroscopic cases observed from 1970 to 2002

We examined 434 cases of death by fall observed at our institution from 1970 to 2002. It emerges from the analysis that the autopsy was performed in only 36% of cases. This low percentage may be referred to factors such the obviousness of death cause and the dynamics of the fact. It was more common amongst males (76%), with a large difference from females. In relation to the modality, suicidal dinamycs was found in 177 cases (40,78%), followed by accidental cause and by accidents at work, both manifested in 127 cases (20,26%), and from the ones due to homicide, observed in 3 cases (0,69%). Relating the modality of falls to gender, in males the great number of cases, 126 (38,07%), was due to accidents at work, followed by accidental precipitation, 104 cases (31,40%), suicides, 98 cases (29,6%) and homicides, 3 cases (0,9%). In females fall was not related to professional activity and the most frequent cause was suicide, 79 cases (76,7%), followed by accidental deaths, 23 cases (23,33%). In suicides, the class of age most representd was 45-80 years, with greater frequency between 50 and 70 years; in accidents at work was 35-65 years with greater frequency from 40 to 50 years; in accidental deaths was 55-94 years with greater frequency between 55 and 65 years. Suicidal precipitation was observed in 146 cases (82,48%) in closed places and in the remaining 31 (17,51%) in opened spaces. The percentage of death in hospital was relevant, 45 cases, representing 25,42% of whole cases and 30,82% of the ones occurred in closed places. All these victims were affected by mental or neoplastic diseases. Within accidental fall we found a prevalence of opened spaces (59%) compared to closed ones (41%). Height varied from 1,5 m to 200 m, but mainly (76,95%) in a range between 1,5 to 20 metres. Relatively to he pole of collision, there is a clear prevalence (69%) of head, followed by thoraco-abdominal region (15%), lower limbs (6,75%), upper limbs (4,75%) and dorso-lumbar region (4,5%).