The correlation between stabbing-related upper extremity wounds and survival of stabbing victims with abdominal and thoracic injuries

Rozenfeld, Michael; Peleg, Kobi; Givon, Adi; Kessel, Boris

Affiliations

¹a Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Ramat Gan, Israel

²Faculty of Medicine, Tel-Aviv University, School of Public Health, Tel-Aviv, Israel

³Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel

Abstract and keywords

Background: When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing.

Methods: This study was carried out retrospectively using data on 8714 patients with stabbing-related injuries from 19 trauma centers that participated in the Israeli National Trauma Registry (INTR) between January 1st1997 and December 31st 2013. Patients with wounds of upper extremities in addition to torso injuries (UE group) were compared to other patients with torso injuries (TO group) in terms of demographics, injury characteristics and clinical outcome.

Results: The compared groups were found to be homogeneous in terms of age and systolic blood pressure; the number of sustained torso injuries was also identical. The UE group comprised a slightly greater percentage of females, however both groups were predominantly male. Patients with upper extremity injuries had a lower proportion of internal organ damage (36% vs. 38.5%) and lower mortality (0.9% vs. 2%). The higher mortality of patients without upper extremity wounds remained significantly different even when adjusted by other epidemiological parameters (OR 2.46, 95% CI 1.33–5.08).The number of sustained upper extremity injuries was positively associated with deeper penetration of the torso by the stabbing instrument.

Conclusions: Patients with stabbing-related upper extremity wounds had a significant survival advantage over patients without such injuries. However, a greater number of sustained upper extremity wounds may be an external sign of greater severity of thoracic and intraabdominal stabbing injuries.

Keywords: Defensive wounds; Penetrating injuries; Torso injuries

Links

DOI: 10.1016/j.injury.2017.04.059

PubMed: 28501286

WoS: 000405997100038

History

Received: 2016-11-02

Revised: 2017-04-26

Accepted: 2017-04-28

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Cited By (2)

Year	Entry
2020	Hogue M, Fairgrieve SI, Lievers WB. Stabbing angle alters peak force and work during sharp force trauma of porcine ribs. Forensic Sci Int. September 2020;314:110373.
2022	Hogue M. Effects of Blade Angle on the Force and Work During Sharp Force Trauma of Porcine Ribs [Master's thesis]. Sudbury, ON: Laurentian University; 2022.