UCLA Center for Health Sciences, Department of Emergency Medicine, Los Angeles, California.
UCLA David Geffen School of Medicine, Los Angeles, California.
West J Emerg Med. 2022 Feb 8;23(2):268-275. doi: 10.5811/westjem.2021.2.50919.
Our goal was to investigate the frequency of specific signs and symptoms following sexual assault-related non-fatal strangulation (NFS) and to explore the interaction between assault characteristics and physical exam findings.
This retrospective observational study included all adults (>18 years) reporting strangulation during sexual assault who presented for a forensic sexual assault exam at one of six urban community hospitals contracted with a single forensic nurse agency. Demographic information, narrative elements, and physical exam findings were abstracted from standardized sexual assault reporting forms. We analyzed data with descriptive statistics and compared specific variables using chi-square testing.
Of the 580 subjects 99% were female, with a median age of 27 (interquartile range 22-35 years). The most common injury location was the neck (57.2%), followed by the mouth (29.1%). We found that 19.1% of the victims had no injuries evident on physical exam and 29.8% reported a loss of consciousness. Eye/eyelid and neck findings did not significantly differ between subjects who reported blows to the head in addition to strangulation and those who did not. The time that elapsed between assault and exam did not significantly correlate with the presence of most head and torso physical exam findings, except for nose injury (P = 0.02).
Slightly more than half of the victims who reported strangulation during sexual assault had visible neck injuries. Other non-anogenital findings were present even less frequently, with a substantial portion of victims having no injuries documented on physical exam. The perpetrators' use of blows to the head may account for many of the non-anogenital injuries observed, but not for the neck and eye/eyelid injuries, which may be more specific to non-fatal strangulation. More research is needed to definitively establish strangulation as the causal mechanism for these findings, and to determine whether any long-term neurologic or vascular sequelae resulted from the observed injuries.
本研究旨在调查性侵犯相关非致命性勒颈（NFS）后特定体征和症状的发生频率，并探讨攻击特征与体格检查结果之间的相互作用。
这是一项回顾性观察性研究，纳入了在与一家法医护士机构签订合同的六家城市社区医院之一接受法医性侵犯检查的所有报告性侵犯中发生勒颈的成年（>18 岁）患者。从标准化的性侵犯报告表中提取人口统计学信息、叙述要素和体格检查结果。我们使用描述性统计数据进行数据分析，并使用卡方检验比较特定变量。
580 名患者中，99%为女性，中位年龄为 27（四分位间距 22-35 岁）。最常见的受伤部位是颈部（57.2%），其次是口腔（29.1%）。我们发现，19.1%的受害者体格检查未见明显损伤，29.8%报告意识丧失。除了勒颈之外，报告头部受到打击的受害者与未报告的受害者之间眼部/眼睑和颈部的检查结果无显著差异。攻击与检查之间的时间间隔与大多数头部和躯干体格检查结果的存在无显著相关性，但鼻损伤除外（P = 0.02）。
报告性侵犯中发生勒颈的受害者中，略多于一半的人有明显的颈部损伤。其他非肛门生殖器的发现则更为少见，相当一部分受害者的体格检查未记录到任何损伤。施害者头部的打击可能导致许多非肛门生殖器损伤，但不会导致颈部和眼部/眼睑损伤，这些损伤可能更特异性地与非致命性勒颈相关。需要进一步研究来明确将勒颈确定为这些发现的因果机制，并确定观察到的损伤是否导致任何长期的神经或血管后遗症。
