Violence-related knife injuries in a UK city; epidemiology and impact on secondary care resources

Abstract

Background: The incidence of knife-related injuries is rising across the UK. This study aimed to determine the spectrum of knife-related injuries in a major UK city, with regards to patient and injury characteristics. A secondary aim was to quantify their impact on secondary care resources. Methods: Observational study of patients aged 16+ years admitted to a major trauma centre following kniferelated injuries resulting from interpersonal violence (May 2015 to April 2018). Patients were identified using Emergency Department and discharge coding, blood bank and UK national Trauma Audit and Research prospective registries. Patient and injury characteristics, outcome and resource utilisation were collected from ambulance and hospital records. Findings: 532 patients were identified; 93% male, median age 26 years (IQR 20À35). Median injury severity score was 9 (IQR 3À13). 346 (65%) underwent surgery; 133 (25%) required intensive care; 95 (17¢9%) received blood transfusion. Median length of stay was 3¢3 days (IQR 1¢7À6¢0). In-hospital mortality was 10/ 532 (1¢9%). 98 patients (18¢5%) had previous attendance with violence-related injuries. 24/37 females (64¢9%) were injured in a domestic setting. Intoxication with alcohol (19¢2%) and illicit drugs (17¢6%) was common. Causative weapon was household knife in 9%, knife (other/unspecified) in 38¢0%, machete in 13¢9%, small folding blade (2¢8%) and, unrecorded in 36¢3%. Interpretation: Knife injuries constitute 12¢9% of trauma team workload. Violence recidivism and intoxication are common, and females are predominantly injured in a domestic setting, presenting opportunities for targeted violence reduction interventions. 13¢9% of injuries involved machetes, with implications for law enforcement strategies.

A 10-year study of penetrating head and neck injury by assault in the North East of England

“…Other studies concur that young males are most likely to sustain these injuries [ 1 , 5 – 7 , 9 , 21 ], most often from knives [ 1 , 6 , 9 ]. Peak occurrence from late evening to early morning is noted elsewhere (particularly Friday, Saturday and Sunday) [ 1 ], with earlier peaks for younger patients [ 21 ]. Annual patterns vary, with peaks noted in summer [ 1 ] and winter [ 9 ].…”

“…Peak occurrence from late evening to early morning is noted elsewhere (particularly Friday, Saturday and Sunday) [ 1 ], with earlier peaks for younger patients [ 21 ]. Annual patterns vary, with peaks noted in summer [ 1 ] and winter [ 9 ]. There may be variations in factors between regions and different years.…”

“…Penetrating injuries are common in the UK comprising 12.9% of Accident and Emergency (A&E) trauma workload [ 1 ]. Causes include inter-personal violence, deliberate self-harm (DSH), accidents and terrorism and include injury with any sharp implement or firearms.…”

“…Head and neck (H&N) penetrating injuries constitute from 3.3 [ 5 ] to 8% [ 1 ] of total penetrating injuries in the UK and are similarly increasing [ 6 ]. These can be shocking to both patients and clinical teams and carry a substantial cost and resource burden to manage [ 1 ].…”

Homicidal Act Commited by an Elderly Person With Sexual Dysfunction. Case Report

“…Over a lifetime, more than 1 of 3 women (35.6%) and more than 1 of 4 men (28.5%) will have experienced physical violence, rape, and/or stalking by an intimate partner (Birkley & Eckhardt 2015;Tharp et al, 2013). Malik et al (2020) studied knife-related injuries and observed that female knife-injured patients were more likely to be injured in domestic violence circumstances (64.9% cases), and 16.2% of them were pregnant at the time of injury (Malik et al, 2020). Recent research has shown that repeated incidents of IPV had been registered by the police and/or by the health-and social care services before an intimate partner homicide case occurred.…”