Sex-Specific Injury Patterns and Clinical Course After Suspected Violent Crime: An Analysis of Data From the...

Injury due to violent crime is a growing problem. 217 000 cases were reported in Germany in 2024, the largest number since 2007. Until now, research has mainly focused on perpetrator profiles and analyses of crime statistics, while sex-specific differences in injury patterns, clinical course, and outcome have not received sufficient attention.

This retrospective, multicenter study included cases of moderate or severe injury (Abbreviated Injury Scale, AIS ≥ 3) probably caused by violence that were documented in the trauma registry of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie; TR-DGU) in the years 2009-2024. The data were analyzed for sex-specific differences in demographic features, injury patterns, clinical course before and during hospitalization, and outcome.

Of the 8759 persons with a documented injury caused by violence, 7324 (83.6%) were male. Stabbing injuries were the most common type (50.3%), followed by blows (33.2%) and gunshot wounds (7.2 %). Compared to the women who sustained injuries from violence, the men were younger (36 vs. 43 years, p < 0.001) and were more often taken to a hospital at night (p < 0.001) or on a weekend (p < 0.001). Women were injured less often but had more serious injuries, more commonly on the neck, face, spine, and pelvis, with a higher mean Injury Severity Score (ISS) (19.2 vs. 15.8, p < 0.001) and a mortality that was nearly twice as high (15.3% vs. 7.9%, p < 0.001).

Our analysis reveals marked sex-specific differences in the pattern and outcome of injuries due to violent crime. Men are more commonly affected, but women sustain more severe injuries and have a higher mortality and worse outcomes. There is an urgent need for preventive measures and for sex-specific approaches to treatment, with appropriate training for doctors and nurses, because hospitals play a key role in the acute care of victims of sex-specific violence.