AI Summary & Key Takeaways
AI InsightOverall, 25.4% of cases were ethanol-positive, and 21.5% sustained injuries that could not be treated with SMI.
📌 3 Key Takeaways
Abstract
Aims: Alcohol consumption is frequently associated with interpersonal violence, but its relationship with injury severity and injury patterns in interpersonal violence remains insufficiently characterized. This study investigated the associations between blood ethanol positivity and medico-legal injury severity, assessed according to the national simple medical intervention (SMI) classification, as well as anatomic injury patterns in adults presenting to the emergency department following interpersonal violence. Methods: Adult patients presenting to a tertiary emergency department between January 2024 and July 2025 with ICD-10 codes related to interpersonal violence were identified through the electronic hospital information system retrospectively. Cases without confirmed interpersonal violence or without blood ethanol testing were excluded. The remaining 586 cases were included; demographic and medical data were recorded. Injury severity was evaluated using the national standard forensic guideline and classified as (1) can be treated or (2) cannot be treated with SMI. Multivariable logistic regression was performed to identify independent predictors of injuries that could not be treated with SMI. Results: The face (62.8%), upper extremities (39.8%), and scalp (33.4%) were the most commonly injured body regions. Overall, 25.4% of cases were ethanol-positive, and 21.5% sustained injuries that could not be treated with SMI. Ethanol positivity was more frequent in nighttime than daytime presentations (33.1% vs. 13.5%, p<0.001). Ethanol-positive cases were more likely than ethanol-negative cases to sustain injuries that could not be treated with SMI (30.2% vs. 18.5%, p=0.003). After adjustment, male gender (adjusted OR 2.699, 95% CI 1.537–4.741, p<0.001), facial injuries (adjusted OR 3.563, 95% CI 2.114–6.007, p<0.001), and ethanol positivity (adjusted OR 1.736, 95% CI 1.096–2.750, p=0.019) remained independent predictors of injuries that could not be treated with SMI. Conclusion: These findings contribute to the understanding of factors associated with medico-legal injury severity in interpersonal violence. Further prospective, multicenter studies incorporating detailed information on assault characteristics and blood ethanol concentrations at the time of injury are warranted to further clarify the relationship between alcohol intoxication and medico-legal injury severity.