Documenting Injuries After a Sexual Assault


BOSTON — Delayed examinations following sexual assaults significantly reduced the frequency of documented anogenital injuries in the victims, based on data from 2,799 cases.

Data on the nature and documentation of anogenital injuries beyond 24-48 hours after a sexual assault are limited, and 72 hours generally is suggested as the maximum time after the assault to document anogenital injuries, Catherine Burger, a medical student at Michigan State University, Grand Rapids, and her colleagues said at the annual meeting of the American College of Emergency Physicians.

The researchers reviewed data from consecutive female patients aged 13 years and older who presented to the community-based Sexual Assault Nurse Examiner program—funded by the Michigan Department of Community Health—during a 10-year period. Their goal was to analyze how the types, location, and frequency of anogenital injuries related to both the victim's age and the time from assault to examination. The researchers also looked for demographic factors that might be linked to the delay in seeking care. A total of 1,192 patients were 19 years or younger (adolescents) and 1,607 were older than 19 years (adults). The results were presented in a poster at the meeting.

A total of 776 victims (26%) delayed seeking medical care for at least 24 hours after an assault. Those who delayed care were significantly younger (20.7 vs. 23.6 years), significantly more likely to have been victimized by a family member or acquaintance (86% vs. 79%), and significantly less likely to report the assault to the police (64% vs. 84%), compared with those who sought care within 24 hours. Adolescents who delayed care were significantly more likely to report alcohol or drug use before the assault, compared with adults who delayed seeking care (58% vs. 47%).

Overall, “the frequency of anogenital lacerations and abrasions decreased from 71% at less than 24 hours to 28% at greater than 96 hours,” the researchers wrote.

In both adolescents and adults, the frequency of documented anogenital injuries dropped by about 8% each day after the assault. But at the 72-hour mark, 50% of adolescents and 38% of adults had documented anogenital injuries. Adolescents had a greater frequency of genital injuries, compared with adults across all time periods.

The results suggest that anogenital injuries can still be documented in medicolegal examinations, even at 72 hours after the assault, the researchers said.

The researchers had no financial conflicts to disclose.

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