Pattern, severity and aetiology of injuries in victims of assault.

Although the incidence of assault and other violent crime is increasing in the UK, the cause and overall pattern of injury, and the need for admission have not been defined in adult victims who attend hospital. In a prospective study, all 539 adult victims of assault attending a major city centre Accident & Emergency department in 1986 were therefore interviewed and examined. Facial injury was extremely common: 83% of all fractures, 66% of all lacerations and 53% of all haematomas were facial. The upper limb was the next most common site of injury (14% of all injuries). Twenty-six per cent of victims sustained at least one fracture and nasal fractures were the most frequently observed skeletal injuries (27%) followed by zygomatic fractures (22%) and mandibular body (12%), angle (12%) and condyle (9%) fractures. Seventeen per cent of victims required hospital admission. Overall, the type of injury observed correlated with the alleged weapon used (P = less than 0.001) though 20% of victims who reported attacks with sharp weapons sustained only haematomas or fractures. Injury most often resulted from punching (72% of assaults) or kicking (42% of assaults). Only 6% of victims reported injury with knives but 11% were injured by broken drinking glasses. Those who were kicked were most likely to need hospital admission.

Recording by the police of violent offences; an Accident and Emergency Department perspective.

The British Crime Surveys have demonstrated that police-derived crime statistics are an unreliable indicator of the true number of violent offences in society. We therefore investigated police recording of consecutive victims of violence who sought treatment in a large Accident and Emergency (A & E) Department. Of victims assaulted within the boundaries of the inner-city Police Division, only one quarter were recorded by the police, though half claimed police awareness of the incident. Proportionately fewer assaults which occurred in the street, in discoteques or on Saturdays were recorded, in comparison to assaults which occurred in other locations and on other days. Proportionately more female victims were recorded, compared to males. A & E data provide a useful insight into the efficiency and effectiveness of inner-city policing. Victims Support Schemes should liaise with A & E Departments as well as with the police.

Assault: characteristics of victims attending an inner-city hospital.

To characterize victims of assault attending a district general hospital, 294 consecutive patients were interviewed and examined. The group included 249 men (median age 23 years, range 13-62 years) and 45 women (median age 23 years, range 15-46 years). The 15-30 years age group, single males, and the unemployed were over-represented (P = less than 0.001). Fewer than expected were professionals or aged 10-15 years or over 50 years. The ethnic background was not significantly different from the Bristol population. Facial injury was extremely common; 89 per cent of fractures, 70 per cent of wounds and 56 per cent of haematomas affected the face. Only 32 per cent of patients were assaulted within their home ward (13 per cent at home) and most assaults took place in the city centre on Fridays and Saturdays, between 11 p.m. and 1 a.m. and in or near public houses and clubs or in the street. Only 29 per cent of assaults were claimed to be unprovoked. Alcohol intake immediately preceding injury was reported by 73 per cent of victims (range 1-34 units) and blood ethanol levels corresponded with this intake. Victims reported police involvement in 54 per cent of cases, but police lists of 'woundings' included only 23 per cent of patients assaulted in central Bristol. Admission of victims was 17 per cent.