Non-firearm weapon use and injury severity

Maxillofacial injury frequently results from violence. Objectives: To test the hypothesis that weapon use results in higher risk of severe injury relative to the use of body parts, and to rank injury severity by assault mechanism. Methods: Representative UK emergency department (ED) attendance assault patient data (n= 25,365) were studied to investigate the relationship between weapon use and injury severity. Manchester Triage Scores (MTS) were used as a measure of injury severity. Results: Ordered logistic regression analyses indicated that the use of a weapon resulted in significantly more severe injury (OR = 1.18, 95% C.I. = 1.06-1.31) than body parts. However, of all mechanisms of violent injury, the use of feet resulted in most severe injury (OR = 1.46, 95% C.I. = 1.24-1.73), followed by blunt objects (OR = 1.38, 95% C.I. = 1.19-1.59), sharp objects (OR = 1.21, 95% C.I. = 1.04-1.41) and body parts (OR = 1.19, 95% C.I. = 1.04-1.35) compared to fists. When number of assailants was included in the model, body parts (OR = 1.22, 95% C.I. = 1.06-1.40) were found to result in more severe injury than sharp objects (OR = 1.09, 95% C.I. = 0.91-1.30), thus suggesting a complex, dynamic relationship between assault and group numbers. Peak age for severe injury was 44 years. Assault by a group significantly increased the risk of severe injury for females. Conclusions: The use of a weapon resulted in more severe injury than use only of body parts. The use of feet caused the most serious injuries whereas fists caused least severe injuries. Injury severity varied by number of assailants, and patient's age and gender. Preventing the use of feet in violence, and group violence, are major priorities for violence prevention in a UK context.