Correlates of Head Injury and Strangulation Among Patients Presenting for Forensic Medical Assessment at an Urban Emergency Department Following Interpersonal Violence

Abstract

Understanding timing of forensic exam and specific acts of interpersonal violence (IPV), such as head trauma and non-fatal strangulation (NFS), related to victim demographics and physical findings can improve screening and assessment. This study aimed to determine the prevalence of various forms of IPV and the breakdown of sex among assailants and victims, to examine the rates of NFS and head injury by type of violence, and their relationship to other indicators of assault severity. As well, this study examined the likelihood of visibility of injury in cases of NFS and head injury during the medical-forensic exam based on the timing between the incident and examination. A retrospective analysis of 1,172 forensic nursing records over 5 years compared victims who reported head impacts and/or strangulation to those who did not. Incident characteristics and injury visibility were assessed. Most victims were female assaulted by males. Among them, 53.5% reported NFS, particularly when the assailant was an intimate partner. Head trauma was associated more with physical than sexual assault. Weapons use correlated with higher reports of head trauma and strangulation. Physical injuries to the head/scalp, neck, and face were more common in these cases and more visible when the forensic exam occurred within 36 hr of the assault. Findings emphasize the importance of timely forensic exams, highlighting key indicators of serious assault, aiding clinical and legal evaluations.