Violence against women in Israel: injury mechanisms and clinical outcomes following hospitalization

Purpose: The objective of this study was to evaluate the relative contributions of different mechanisms of assault to injury and mortality in women in Israel. Methods: We identified females hospitalized between 2011 and 2020 following an assault, secondary to blunt, stabbing, or shooting mechanisms of injury, in the Israeli Program for Registration of Trauma Patients (National Trauma Registry). To avoid bias due to temporary hospitalizations for non-medical reasons, we included patients with injuries graded as Abbreviated Injury Scale ≥ 2. Results: Females accounted for 8.1% (926/11,486) of assault patients in the study population. Compared to males, females were older (40.7 vs. 31.0 years; p < 0.001), more commonly injured by the blunt trauma mechanism (72.1 vs. 48.6%; p < 0.001), and more commonly injured at a place of residence (50.9 vs. 8.2%; p < 0.001). There were no differences in the number of body areas injured, severe Injury Severity Score, and median hospitalization. Males were operated more commonly (44.6 vs. 40.0%; p = 0.008). Mortality in females and males was similar (2.8 vs. 2.3%; p = 0.43). Secondary analysis revealed that blunt injuries were responsible for 61.2% of the severe cases (ISS ≥ 16), 61.4% of the operations, 54.9% of the Intensive Care Unit (ICU) admissions, and 53.8% of the mortality observed in females. When compared to males injured by blunt trauma, females injured by this mechanism were older (43.0 ± 24.7 vs. 32.8 ± 16.1 years; p < 0.001) and had higher mortality (2.1 vs. 0.9%; p = 0.007). Conclusions: Assault by mechanisms other than stabbing and shooting should be recognized as a source of severe morbidity and mortality in females.