• Pantelis Hadjizacharia, David S Plurad, Donald J Green, Joseph DuBose, Rodd Benfield, Anthony Shiflett, Kenji Inaba, Linda S Chan, and Demetrios Demetriades.
• Department of Surgery, Division of Trauma/Surgical Critical Care, Los Angeles County and the University of Southern California Medical Center, Los Angeles, California 90033, USA.
• J Trauma. 2009 Apr 1;66(4):1202-6.

BackgroundPhysical assault is common in trauma patients. Penetrating injuries resulting from interpersonal violence have been well described in literature, but there have been few studies examining the injury patterns due to assaults with hands and feet or blunt instruments.MethodsThe Trauma Registry of an American College of Surgeons Level I center was queried for all patients with an E-code diagnosis of assault by hands and feet or blunt instrument for the period of January 1, 1992 to September 30, 2005. Demographic and injury pattern data were analyzed. Univariate and multivariable analysis was performed to identify independent predictors of mortality.ResultsThere were 3,286 patients identified (89.7% male) with a mean age of 36 years +/- 13 years and mean injury severity score of 8 +/- 7. Overall, 65 (2.0%) patients required laparotomy, 10 (0.3%) required craniectomy, and 1 (0.03%) patient required thoracotomy. Traumatic brain injury was present in 66.5% (2,184). Mortality was 2.4% (80). Patients older than 55 years were more likely to be severely injured (injury severity score > or = 16) (23.4% vs. 14.6%, p < 0.001) and were more likely to die of injuries (4.8% vs. 2.1%, p < 0.05). Nineteen (0.6%) patients had documented fractures of the cervical spine and cervical spinal cord injury was not observed in any patient.ConclusionsInjuries due to assault rarely require operative intervention and have a low risk of cervical spine or cord injuries. However, many result in traumatic brain injury. Patients older than 55 years tend to be more severely injured and at higher risk of mortality.

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