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. 2024 May 20;30(3):188-193.
doi: 10.1136/ip-2023-045107.

Assault-related anoxia and neck injuries in US emergency departments

Bharti Khurana  1   2 , Jaya Prakash  3   4 , Annie Lewis-O'Connor  2 , William Green  5 , Kathryn M Rexrode  2 , Randall T Loder  6
Affiliations

Assault-related anoxia and neck injuries in US emergency departments

Bharti Khurana et al. Inj Prev. .

Abstract

Background: Early identification of non-fatal strangulation in the context of intimate partner violence (IPV) is crucial due to its severe physical and psychological consequences for the individual experiencing it. This study investigates the under-reported and underestimated burden of IPV-related non-fatal strangulation by analysing assault-related injuries leading to anoxia and neck injuries.

Methods: An IRB-exempt, retrospective review of prospectively collected data were performed using the National Electronic Injury Surveillance System All Injury Programme data from 2005 to 2019 for all assaults resulting in anoxia and neck injuries. The type and mechanism of assault injuries resulting in anoxia (excluding drowning, poisoning and aspiration), anatomical location of assault-related neck injuries and neck injury diagnosis by morphology, were analysed using statistical methods accounting for the weighted stratified nature of the data.

Results: Out of a total of 24 493 518 assault-related injuries, 11.6% (N=2 842 862) resulted from IPV (defined as perpetrators being spouses/partners). Among 22 764 cases of assault-related anoxia, IPV accounted for 40.4%. Inhalation and suffocation were the dominant mechanisms (60.8%) of anoxia, with IPV contributing to 41.9% of such cases. Neck injuries represented only 3.0% of all assault-related injuries, with IPV accounting for 21% of all neck injuries and 31.9% of neck contusions.

Conclusions: The study reveals a significant burden of IPV-related anoxia and neck injuries, highlighting the importance of recognising IPV-related strangulation. Comprehensive screening for IPV should be conducted in patients with unexplained neck injuries, and all IPV patients should be screened for strangulation events.

Keywords: Asphyxia; Contusions; Hypoxia; Intimate Partner Violence; Neck Injuries; Violence.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1:
Figure 1:
Percentage incidence of different mechanisms contributing to 22,764 assault-related anoxia cases reported in the NEISS AIP database from 2005 to 2019 based on the type of assault.
Figure 2:
Figure 2:
Percentage anatomic distribution of injuries based on the etiology of 24,493,518 injuries from assaults (after excluding “unknown”) reported in the NEISS AIP database from 2005 to 2019.
See this image and copyright information in PMC

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