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Temporal and geographic patterns of stab injuries in young people: a retrospective cohort study from a UK major trauma centre
  1. Paul Vulliamy1,
  2. Mark Faulkner2,
  3. Graham Kirkwood3,
  4. Anita West4,
  5. Breda O’Neill4,
  6. Martin P Griffiths4,
  7. Fionna Moore5,
  8. Karim Brohi1,4
  1. 1 Centre for Trauma Sciences, Queen Mary University of London, London, UK
  2. 2 London Ambulance Service NHS Trust, London, UK
  3. 3 Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK
  4. 4 Trauma Service, The Royal London Hospital, Barts Health NHS Trust, London, London, UK
  5. 5 South East Coast Ambulance Service NHS Foundation Trust, Crawley, UK
  1. Correspondence to Dr Paul Vulliamy; p.vulliamy{at}


Objectives To describe the epidemiology of assaults resulting in stab injuries among young people. We hypothesised that there are specific patterns and risk factors for injury in different age groups.

Design Eleven-year retrospective cohort study.

Setting Urban major trauma centre in the UK.

Participants 1824 patients under the age of 25 years presenting to hospital after a stab injury resulting from assault.

Outcomes Incident timings and locations were obtained from ambulance service records and triangulated with prospectively collected demographic and injury characteristics recorded in our hospital trauma registry. We used geospatial mapping of individual incidents to investigate the relationships between demographic characteristics and incident timing and location.

Results The majority of stabbings occurred in males from deprived communities, with a sharp increase in incidence between the ages of 14 and 18 years. With increasing age, injuries occurred progressively later in the day (r2=0.66, p<0.01) and were less frequent within 5 km of home (r2=0.59, p<0.01). Among children (age <16), a significant peak in injuries occurred between 16:00 and 18:00 hours, accounting for 22% (38/172) of injuries in this group compared with 11% (182/1652) of injuries in young adults. In children, stabbings occurred earlier on school days (hours from 08:00: 11.1 vs non-school day 13.7, p<0.01) and a greater proportion were within 5 km of home (90% vs non-school day 74%, p=0.02). Mapping individual incidents demonstrated that the spike in frequency in the late afternoon and early evening was attributable to incidents occurring on school days and close to home.

Conclusions Age, gender and deprivation status are potent influences on the risk of violent injury in young people. Stab injuries occur in characteristic temporal and geographical patterns according to age group, with the immediate after-school period associated with a spike in incident frequency in children. This represents an opportunity for targeted prevention strategies in this population.

  • trauma management
  • public health
  • violence reduction
  • paediatrics

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  • Contributors PV, FM and KB conceived the study. PV, MF, AW, GK, BON, MPG and KB contributed to data collection and analysis. PV and KB wrote the initial draft of the manuscript. All authors contributed to critical revisions of subsequent manuscript drafts and approve of the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval NRES Committee South Central - Berkshire B (reference 15/SC/0547).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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