Stabbing: data support public perception

Editor—Last year Hern et al published an editorial on knife crime and clearly the problem has not gone away.¹ A quick search of the Times website finds 90 hits on the single search term “stabbing” in the past three months alone. Several recent deaths have fuelled the perception that forensic knife injuries have become an epidemic, resulting in a knife amnesty and government discussion of new punitive measures. An increase in such injuries is supported by data from regional police forces and the Home Office, with 1200 reported attacks in London last year and 30% of homicides caused by knife injury.² Crimes defined as “more serious wounding or other act endangering life” almost doubled nationally from 1995 to 2005.³

We audited forensic knife injuries at this hospital, one of Europe's busiest emergency departments, to establish the size of this problem in a representative urban area (east London). We extracted data on forensic knife injuries (excluding deliberate self harm) from a detailed prospectively recorded database of all trauma calls from July 2004 to June 2006 (these reflecting more severe injuries). Overall there were 309 forensic knife injuries; 259 patients were admitted, 184 were operated on, and eight died. The chest was the most common area injured (183/309 patients, 6/8 deaths). Most patients were men (297/309), and mean age was 28 (range 15-74).

To give a measure of changing incidence over a longer time of a greater range of severity of injury, we also performed an audit of all cases coded as “stabbing” on the patient administration system during the 10 year period from July 1997 to June 2006 (figure).

Figure 1.

Numbers of attendances coded as stabbing at Royal London Hospital

Over both periods, the data show an increase in the overall incidence of stabbings. Furthermore, increased need for surgical intervention in the prospective study may reflect increasing severity of injury. These data therefore seem to support the general perception that knife injuries are increasing.