You cannot have missed the UK media stories about the increase in stabbings in young people; and the data from hospitals in London supports this. This week saw the publication of an article in BMJ Open sharing data from stabbing presentations to a major trauma centre in London.
Where and when do young people get stabbed, and (perhaps more importantly) how can this information inform our violence reduction strategy?
Vulliamy P, Faulkner M, Kirkwood G, et al. Temporal and geographic patterns of stab injuries in young people: a retrospective cohort study from a UK major trauma centre, BMJ Open 2018;8:e023114. doi: 10.1136/bmjopen-2018-023114
Who were the patients?
This was a retrospective cohort study in a major trauma centre in London. It included all patients under 25 years of age who presented following injury from a knife or other sharp object (and who met the criteria for triggering a trauma team activation).
Patients were excluded if the injuries were due to self-harm or were accidental.
It’s also important to understand some key definitions that the authors used (based on WHO categorisation):
- childhood – <16 years
- late adolescence – 16-19 years
- young adulthood – 20-25 years
What were they looking at?
The authors looked at the time of the incident, geographic location, and the demographics of the patients.
What were the numbers?
During the ten year period (2004-2014) 1824 patients under 25 years of age presented with stab injuries. This group represented 56% of the total number of penetrating injuries.
Perhaps most alarmingly, during the ten year period of this study, the number of presentations increased 25% each year.
Who were the victims?
They comprised of: 9.4% children; 47.2% were in late adolescence; and 43.4% were young adults. Although there were no major differences across the three ages groups, this study did note that in-hospital mortality was higher in the youngest age-group. However, overall mortality was only 2%.
97% were male and 71% of victims lived in the most deprived areas.
Where and when did the stabbings happen?
In the paediatric age group, there was significant peak in incidents between 1600hrs and 1800hrs (22%) in comparison to the adolescent or young adult groups (11%). Young adults were more likely to be stabbed after midnight.
The authors then did an analysis comparing timings of the incidents on school days versus non-school days. They found that more children were stabbed on a school day and that these incidents tended to happen earlier than on a non-school day. Incidents were more likely to happen within 5km of their home on a school day.
In fact, looking specifically at children, 47% of incidents happened within 5km of their home when they occur on a school day.
What does all this mean?
This data describes the young victims of knife crime in the UK and highlights the fact that children are more at risk of being victims of knife crime after school and near their home. This has important implications on how we can target violence reduction projects.
The authors outline a strategy used in Glasgow to reduce their knife crime rates – their multi-disciplinary approach, supported by the government and the broader community, has led to a large reduction in knife crime. They go on to make some specific suggestions for how to target knife crime in young people given the data obtained from this cohort study:
- delivering educational interventions in secondary school or even as early as primary school
- staggered release times from school
- police presence to act as a deterrent where children are known to congregate after school (transport stations, cafes)
- using a ‘stop and search’ strategy
This is a hugely important study that hopefully will continue to build on our current efforts to target violence amongst young people.
And if you prefer an infographic then check out this one:
(COI – Tessa: I work with many of the authors of this paper but had no involvement in the study)