Prevalence of strangulation in survivors of sexual assault and domestic violence

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• 作者：Colleen Mcquown ; MD^a ; ^b ; ^{mcquownc@summahealth.org" class="auth_mail" title="E-mail the corresponding author} ; ^{mcmcquown@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Jennifer Frey ; PhD^a ; ^{freyja@summahealth.org" class="auth_mail" title="E-mail the corresponding author} ; Sheila Steer ; MD^a ; ^b ; ^{steers@summaehealth.org" class="auth_mail" title="E-mail the corresponding author} ; Gwendolyn E. Fletcher ; MD^a ; ^b ; ^{fletcherg@summahealth.org" class="auth_mail" title="E-mail the corresponding author} ; Brett Kinkopf ; MD^a ; ¹ ; ^{davidnaillpiper@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Michelle Fakler ; MD^a ; ² ; ^{mfakler@bidmc.harvard.edu" class="auth_mail" title="E-mail the corresponding author} ; Valorie Prulhiere^a ; ³ ; ^{vkwp13@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Emergency Medicine
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：34
• 期：7
• 页码：1281-1285
• 全文大小：462 K

文摘

Both sexual assault (SA) survivors and domestic violence (DV) survivors are populations at risk of strangulation injury. Our goal was to identify the prevalence of strangulation in patients who are survivors of SA and DV, identify presence of lethality risk factors in intimate partner violence, and assess differences in strangulation between SA and DV populations.

Methods

We reviewed all patient encounters from our health system's SA/DV forensic nurse examiner program from 2004 to 2008. Medical records were reviewed for documented physical signs of strangulation or documentation of strangulation. Risk factors for lethality included presence of firearm, threats of suicide/homicide by the perpetrator, significant bodily injury, loss of consciousness, loss of bladder or bowel control, voice changes, or difficulty swallowing. Data were analyzed with Pearson χ² and 95% confidence intervals (CIs).

Results

A total of 1542 encounters were reviewed. The mean patient age was 30 (range, 13-98) years and 97% were female. Six hundred forty-nine encounters were for DV assaults and 893 were SA. An intimate partner was the assailant 46% of the time; 84% DV vs 16% SA (P < .001). Patients reported strangulation in 23% (351/1542; 95% CI, 21%-25%) of their assaults. The prevalence of strangulation was 38% with DV and 12% with SA (P < .001). Most of the intimate partner encounters with strangulation had significant risk for lethality (97%, 261/269; 95% CI, 94%-99%).

Conclusions

Patients presenting to our forensic nurse examiner program who were survivors of DV were more likely than SA patients to sustain strangulation. Lethality risk factors were common.