Improved medical treatment could explain a decrease in homicides with a single stab wound
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ORIGINAL ARTICLE
Improved medical treatment could explain a decrease in homicides with a single stab wound Asser H. Thomsen 1 & Palle Villesen 2,3 & Ole Brink 1,3 & Peter M. Leth 4 & Hans Petter Hougen 5 Accepted: 9 March 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Since the 1990s, there has been a reduction in the homicide rate in Denmark and other Western countries. Our hypothesis is that part of the decrease in the sharp force homicide rate can be explained by better and faster medical treatment over time, and we explore this via stab wound homicides, the largest group of homicides in Denmark. To investigate our hypothesis we undertook an epidemiological study of 428 stab wound homicides in Denmark 1992–2016 based on autopsy reports with registration of stab wounds, quantification of injury severity, treatment intensity and survival time. During 1992–2016, there was a significant reduction in the annual number of victims with a single stab wound, but no reduction in victims with multiple stab wounds. Victims with single stab wounds reached the hospital more often, survived longer and had less severe injuries (New Injury Severity Score (NISS)) than victims with multiple stab wounds. Higher NISS correlated with shorter survival time for all the stab wound victims and for the subgroup that underwent medical treatment. During the 25-year study period, the proportion of victims who underwent surgery before dying increased threefold. The victims in the first half of the study period had shorter survival times than the victims in the last half. We concluded that better and faster medical treatment could partly be responsible for the observed decrease in the number of single stab wound homicides and thereby possibly also in the total number of stab wound homicides. Keywords Homicide . Sharp force trauma . Interpersonal violence . Forensic pathology . Trauma severity
Introduction The homicide rate in the Western world has decreased since the 1990s [1–4]. This pattern can be explained by factors before, during and after the homicidal event. There are many
psychosocial factors leading up to homicidal events that can explain part of the decrease, such as changing patterns in substance abuse, mental illness and unemployment [1, 5–7]. During an assault, the choice of weapon, the extent of violence and the victims’ physical disposition influence whether the victim dies
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12024-020-00246-z) contains supplementary material, which is available to authorized users. * Asser H. Thomsen [email protected] Palle Villesen [email protected] Ole Brink [email protected] Peter M. Leth [email protected] Hans Petter Hougen [email protected]
1
Department of Forensic Medicine, Aarhus University, Palle Juul-Jensen Boulevard 99, 8200 Aarhus N, Denmark
2
Bioinformatics Research Centre, Aarhus University, CF Moellers Alle 8, 8000 Aarhus C, Denmark
3
Department of Clinical Medicine, Aarhus University, Aarhus
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