Incidence and outcomes of major trauma assaults: a population-based study in Victoria

OBJECTIVE: To describe the incidence and outcomes of assault resulting in serious injury in Victoria. DESIGN AND SETTING: Analysis of population-based data from the Victorian State Trauma Registry for assaults between 1 July 2001 and 30 June 2007. MAIN OUTCOME MEASURES: Overall trends in the rate of assault-related major trauma, inhospital mortality, and functional outcomes 6 months after injury as measured by the Extended Glasgow Outcome Scale. RESULTS: The rate of assault-related major trauma rose significantly over the 6-year study period (incidence rate ratio [IRR], 1.21 [95% CI, 1.16-1.26]), particularly for blunt assault (IRR, 1.33 [95% CI, 1.26-1.41]). There were 803 admissions for major trauma related to assault: 484 (60%) were for blunt trauma and 319 (40%) for penetrating trauma. Most patients were young men. Compared with penetrating trauma, blunt trauma was associated with more severe injury; 396 patients (82%) with blunt trauma had serious head injuries, and 102 (24%) of these required inpatient rehabilitation. A higher percentage of patients with penetrating trauma died in hospital compared with those with blunt trauma (35 [11%] v 23 [5%]; P = 0.001). Follow-up at 6 months showed that only 19% of respondents (42 patients) had made a complete recovery; outcomes at 6 months were worse for patients with blunt trauma than for those with penetrating trauma. CONCLUSIONS: The incidence of assault resulting in severe trauma rose significantly between 2001-02 and 2006-07, mostly due to a rise in assault resulting in blunt trauma. The increase in incidence, the young age of the victims, and the potential for high burden of injury and poor outcome, combined with the preventable nature of assault, highlight the importance of developing effective assault-prevention strategies.