Sharp Force Homicide in Denmark 1992–2016

Sharp force trauma is a common homicide method. The weapon is typically a knife, which is easily accessible and does not require special skills. We have analyzed all 471 sharp force homicides in Denmark during 1992–2016 with special focus on aspects that are relevant to forensic pathologists, including the distribution of wounds and organ injuries. Most homicides were committed inside with a kitchen knife. The front left thorax was the most common area to be affected by sharp force trauma. In 18.9% of the victims, there was only one sharp injury, the majority on the thorax. The most common trajectory for stab wounds was directly posterior with no deviation to the sides or up/down followed by directly anterior. The heart (including pericardium) and lungs (including hemo- and pneumothorax) had injuries in more than 75% of the victims. 67% of victims were males. Female victims had more sharp force injuries and defense wounds than male victims. Most females were killed in domestic homicides (73.7%), most commonly in partner killings (56.4%). In contrast, many male victims were killed in a setting of nightlife/intoxication (34.0%) most by a friend/acquaintance delivering a few stab wounds. The results clearly show strong sex differences in both victims and offenders. This could be useful for shaping policies and public opinion, and as a route for understanding the developments in interpersonal violence. In the narrow setting of death investigation, our results will provide an evidence-based approach to understanding the injury patterns in sharp force homicide.     

Weapon Use in Korean Homicide: Differences Between Homicides Involving Sharp and Blunt Instruments

On the basis of information regarding 276 homicides committed in South Korea between 1987 and 2008, we compared offenders’ and victims’ characteristics, injury locations, weapon‐related behavior, and offending behavior between homicides involving sharp and blunt instruments. The victims of sharp‐force homicide were much younger relative to those of blunt‐force homicide. In addition, homicides involving blunt instruments were more likely to be committed by offenders who lived with the victims. Most sharp‐force homicides involved injuries to the torso, while blunt‐force homicides involved mainly head injuries. Furthermore, perpetrators of sharp‐force homicides tended to preselect their weapons, while those of blunt‐force homicides were likely to use weapons of opportunity. Logistic regression analysis identified a number of factors, including injury location and body transportation, which significantly predicted weapon type. As this was the first South Korean study to compare sharp‐ and blunt‐force homicides, the results have practical implications for homicide investigations.     

Multivariate analysis (`Forensiometrics')—A new tool in forensic medicine: Differentiation between sharp force homicide and suicide

Multivariate projective statistical methods (PCA, PLS-DA) and logistic regression analysis were used to create models to make predictions regarding whether a certain fatality shows similarities to homicide or suicide. The `model set' consisted of 174 deaths due to sharp force injuries that in previous medicolegal investigation had been judged as homicides and 105 as suicides. The models were then validated on a new set of 40 homicides and 27 suicides that had not been used to create the models (test set validation). The model based on the PLS-DA technique had regarding its ability to identify homicides a sensitivity of 40/40=100% and a specificity of 25/27=93%. The model's predictions agreed with previously performed medicolegal investigations except in two suicides which according to the model were likely to be homicides. The reliability of this model was somewhat better than predictions achieved by means of logistic regression analysis, where six otherwise proven homicides were wrongly classified as suicides and two actual suicides were misclassified as homicides. The technique not only identifies variables but also ranks their importance. Ranked according to falling positive correlation (falling `importance' of a finding) to the dependent variable `death caused by homicide', the predictors were: Injuries to clothing, blood alcohol level, presence of defence injuries, injuries due to other type of violence than sharp force, chest stabs with vertical axis of the entrance wound, sharp force injuries to the upper extremity (except wrist and crook of the arm), sharp force injuries to the head and back. Ranked in increasing positive correlation to `death caused by suicide' were the predictors: sharp force injuries to the crook of the arm, venue being the victim's home, presence of farewell letter, victim's age, sharp force injuries to the wrist, known suicidal ideation and presence of tentative injuries.     

Differences between Homicides Committed by Lone and Multiple Offenders in Korea

The aim of this study was to differentiate between homicides committed by multiple offenders and homicides committed by lone offenders. Using data on homicide incidents that occurred in South Korea between 1985 and 2008, we compared 134 homicides committed by multiple offenders, with 369 homicides committed by lone offenders. A greater proportion of homicides committed by multiple offenders involved injuries to the victim's head compared to homicides by lone offenders. Homicides committed by multiple offenders were more likely to involve blunt instruments and ligatures, whereas homicides by lone offenders were more likely to involve sharp instruments. In addition, a majority of the homicides committed by multiple offenders were planned. The results of this study have practical implications for homicide investigations, as well as theoretical implications for homicide research on the difference in offense behaviors based on the number of offenders.     

Sharp Force Injury Fatalities: A Retrospective Study (1982–2012) in Brescia (Italy)

A retrospective study was carried out on postmortem examination data of 131 sharp force‐related casualties recorded by the Brescia Institute of Forensic Medicine between 1982 and 2012. The objective was to identify relevant parameters that may be used to distinguish the manner of deaths between homicide, suicide, and accident. The following variables were considered: manner of death; demographic data; scene; type of sharp object; location and numbers of wounds; the presence of hesitation marks/defense wounds; toxicological findings; psychiatric history. There were 92 homicides, 28 suicides, and 11 accidents. Most victims were male, with an average age of 43. Injuries in isolation were present in 9.8% of homicides, in 35.7% of suicides, and in 54.5% of accidents. Most injuries involved the left anterior chest in homicides and the forearms in suicides. This study underlines the importance of a meticulous postmortem examination of injuries on the body and their relationship with other results from the death scene investigation.     

Comparison of wound patterns in homicide by sharp and blunt force

A comparison of patterns of injuries between sharp force and blunt force homicide was performed. Male predominance was seen in both types of homicides. Most of the victims of sharp force were between 21 and 40 years and those of blunt force between 31 and 40 years. There was no difference in the incidence of victims below 20 years age, but blunt force was almost five times more than sharp force in victims of age above 60 years. Thorax was the commonest site to be involved in sharp force in contrast to head in blunt force. Hand and forearm were the commonest sites of defence injuries in sharp and blunt force homicides, respectively. The majority of the blunt force victims had lesions in only one region in contrast to involvement of 2-4 regions in sharp force. The majority of the victims were killed by acquaintances in blunt force, but criminals always prefer sharp force to kill their victims. Single weapon was more commonly used in blunt force as compared to sharp force. Knife and wooden/iron rods were the weapons of choice in their respective categories. Most of the victims of sharp force were killed outdoor in contrast to victim's own domicile in blunt force.     

Sharp injury fatalities in New York City

We reviewed the case records of all fatalities due to sharp injuries in New York City in 1999. The epidemiological profile, circumstances, toxicology results, location, and injuries were examined. There were 120 deaths: 101 homicides, 17 suicides, and 2 accidents. The causes of death included: 112 due to stab(s) with or without incised wounds and 8 pure incised wound fatalities of which 5 were suicides. The detection of ethanol and/or illicit drugs was 61% in the homicide and 12% in the suicide groups. "Defense wounds" were reported in 49% of the homicides and "hesitation" wounds were found in 65% of the suicides. There were no self-inflicted sharp injuries of the face. Deaths due to a single stab wound occurred in 34% (34/101) of the homicides and 24% (4/17) of the suicides. Of these 38 deaths, 58% were of the anterior thorax (chest) and 71% injured the heart and/or great vessels. The remaining deaths with single stab wounds involved the femoral artery, abdominal organs, or head. There were no sharp injury suicides by Hispanics, Asians, or anyone under the age of 18 years. Over half of the suicides at home occurred in the bathroom and 78% of these occurred in the bathtub. Suicide notes were found in 24% of suicides, and an additional 24% verbally expressed a plan to commit suicide.     

Women, homicide and alcohol in Cape Town, South Africa.

Little is known about the complex circumstances culminating in the homicidal death of a woman. The records of 248 female homicides and suicides admitted to the Salt River State Mortuary between January 1990 and July 1991 were reviewed with specific attention to mode of death and blood alcohol concentration (BAC). Female homicide levels reflected the intensity of violence in specific residential areas. White females were far more likely to die a suicidal, as opposed to homicidal, death (Odds Ratio = 31.94; 95% Confidence Interval, 11.63-90.24). Blunt homicide predominated amongst White females, who were substantially older than the Coloured and African subjects. A BAC greater than 0.1 g per 100 ml was found in 56% of all female homicides studied. An association was found between increasing BAC and sharp homicide amongst women. A high BAC may represent a self-destructive element in a risk-taking situation amongst female homicide victims.     

Multivariate analysis ('forensiometrics')--a new tool in forensic medicine. Findings on the victim of sharp-force homicide can predict the inter-relationship with the perpetrator.

A multivariate 'forensiometric' technique (PLS-DA) was used to create a model to predict the relationship between homicide victim and perpetrator on a five-level scale: strangers, acquaintances, drinking companions, relatives and spouses. The model is based on findings on the victim and at the venue, and uses the following ten variables as 'predictors', listed in falling order of covariation with instances of close relationship between victim and perpetrator: Victim found in home, female victim, a single sharp injury, injuries to the upper extremity, superficial sharp injuries to the chest ('scratches'), ten or more sharp injuries, presence of defence injuries, total number of sharp injuries, male victim, and victim found outdoors. The model was based on 87 sharp-force homicides (the model-set) and was validated on another set of 43 sharp-force homicides (the test-set). In this test-set validation, 17 of 39 cases (44%) were correctly predicted according to the results of earlier combined forensic and police investigations, and a prediction one step away from the correct level was given in another 17 cases. These results were significantly better than would have been obtained by chance.     

Homicide in Cape Town, South Africa

All autopsies performed on homicide victims at the Salt River police mortuary, Cape Town, in the first 6 months of 1986 were reviewed. Most of the homicides that had occurred in Cape Town were as a result of stab wounds to the chest. Smaller, but significant, numbers of homicides were as a result of stab wounds to the head and neck, blunt injury to the head, or gunshot wounds. Homicidal burning also has occurred in civil unrest situations. Infanticide was rarely encountered. Alcohol was detected in the homicide victims in 62.9% of cases; 8.4% had a blood alcohol concentration higher than 0.30 g/100 ml. Our figures confirm that Cape Town has one of the highest homicide rates in the world (56.9/100,000 per annum for 1986). Homicides in Cape Town are characterized by assaults with sharp instruments, usually knives, although "pangas," or cane knives, are also commonly used.     

Homicidal and suicidal sharp force fatalities in Stockholm,Sweden.: Orientation of entrance wounds in stabs gives information in the classification

A comparative study of 174 homicidal and 105 suicidal sharp force deaths in the Stockholm area is presented in order to identify variables of importance in the differentiation between homicides and suicides. In homicides, a significantly (p<0.05) higher number of cut and stab wounds were seen in the head, upper and lower extremities and a significantly higher number of vertical stab wounds were found in the chest. Lower numbers were seen in the wrist and the crook of the arm. When counting the injured areas, irrespective of the number of injuries, abdominal wounds and horizontal chest stab wounds were also significantly more often found in victims of homicide. Injuries to the back and to the genitals were not seen in suicides. The suicide victims were significantly older and had significantly lower blood alcohol levels. A new variable pointing at a statistically significant difference between homicides and suicides was found: In homicides, stab wounds with a horizontal axis of entrance wound in the chest was found to be less common than those with a vertical axis. Other variables studied were prevalence of defence and tentative wounds, farewell notes and suicidal ideation, earlier parasuicides, venue, gender of the victims and the types of sharp objects used.     

A 28-year (1963-90) study of homicide in Marion County, Oregon.

We describe 240 consecutive homicidal deaths that occurred in Marion County, Oregon, over a 28-year period (1963-90). An epidemiological assessment of the homicides yielded the following information: More than 91% of these deaths were primary homicides. In primary homicide, 63% of the victims and 88% of the offenders were male. In secondary homicide, 76% of the victims and all of the offenders were male. A high percentage of victims (83%) and offenders (84%) in primary homicide were Caucasian, as were 100% of victims and offenders in secondary homicide. About 12% of victims and 10% of offenders in primary homicide were Hispanic. Fifty-nine percent of primary homicides were intrasexual, as compared to 87% of secondary homicides. An intraracial pattern was found in 90% of primary homicides and in 100% of secondary homicides. The most frequent means of death in both primary and secondary homicides were firearms, physical beating, and stabbing. Strangers committed 80% of secondary homicides. This was in marked contrast to the victim-offender relationship found in primary homicides, where strangers were responsible for approximately 16% of the total, acquaintances for approximately 36%, and family members for approximately 48%. The overall clearance rate (i.e., the identification and charging of a suspect for the death) was 88%.     

Cardiopulmonary resuscitation-related injuries and homicidal blunt abdominal trauma in children

Defendants accused of inflicting fatal abdominal injuries to children occasionally raise the defense that the injuries were caused by cardiopulmonary resuscitation (CPR). The purpose of this study is to answer the question: Does closed chest CPR result in fatal blunt abdominal injuries that can be mistaken for homicidal assault? To that end, a retrospective study was conducted of all homicidal blunt abdominal injuries in children 10 years and younger from the Dade, Broward, and Palm Beach Medical Examiner's Offices from 1981 through 1997. These were compared to cases of children who died of natural causes during the same time period in Broward County who had CPR (control group 1) and to children who died of nonvehicular accidental blunt abdominal trauma (control group 2). Children with life-threatening head injuries were excluded. Medical examiner records, autopsy reports, documenting photographs, and clinical records were reviewed. The data analyzed included subject demographics, whether CPR was performed and by whom, and autopsy findings. Thirty-three child homicides with fatal abdominal injuries were reviewed. Twenty-four (73%) of the homicides received CPR. There was no difference in the nature and severity of injuries between the 24 children who received CPR and the 9 who did not. Three hundred and twenty-four cases of pediatric natural deaths were reviewed, all of which had CPR. No traumatic abdominal injuries were found in any of the children who died of natural causes. Only four children who died of natural causes had evidence of extraabdominal trauma related to CPR. No cases of nonvehicular accidental blunt abdominal trauma were identified during the 17-year period, although there were nonvehicular accidental fatalities due to extraabdominal injuries. The likelihood of CPR-related primary abdominal trauma in child homicides is very low.     

Child homicide in Cologne (1985–1994)

Twenty five child homicides investigated in the Cologne University Institute of Forensic Medicine from 1985–1994 were retrospectively analysed with special reference to the evidential value of the autopsy findings and possible peculiarities related to the infants physiological condition. About 65% of the victims were boys younger than 3 years. About 65% of the child homicides were committed by the mother in the parental flat, predominantly in the early hours of the evening during the weekend. The mode of death were 10X blunt injury, 6X sharp violence, 6X strangulation, 3X smothering, 2X drowning, 2X gunshot and 5X neglect (starvation). The defenseless, helpless and immobile condition of the infant particularly favours a homicide by manual assault, smothering or neglect (starvation).     

Body Transportation after Homicides: Offender and Offense Characteristics

Body transportation is defined as moving the body of the victim from the scene of a homicide to another location. We analyzed data on 513 South Korean homicide cases with convictions to compare 104 homicides involving the transportation of victims’ bodies with 409 homicides that did not. Offenders who transported their victims’ bodies were significantly younger and more likely to be related to the victims and were less likely to use sharp instruments and more likely to use blunt instruments or strangle the victims than offenders who did not. Victims of homicide involving body transportation were more likely to suffer injuries to the neck and head and less likely to suffer injuries to the torso. Finally, offenders who transported victims’ bodies were more likely to have planned the offense and destroyed evidence. The present findings have practical implications for police investigations.     

A decade of pediatric homicide: a retrospective study at the Medical University of South Carolina.

More than 3 million children are abused and/or neglected each year in the United States. Unfortunately, a significant percentage of these cases result in homicide by child abuse or child neglect. Causes of death range from blunt force trauma and shaking to asphyxia to immolation. We retrospectively reviewed all pediatric forensic cases referred to the Medical University of South Carolina Forensic Pathology Section over the past 10 years, from January 1986 to December 1995. Of these, we looked only at children < or =5 years of age. The majority (342 cases, 69%) of these deaths were classified as natural, 96 (19%) as accident, and 60 (12%) as homicide. Of the homicides, we examined the cause of death; age, gender, and race of the victim; relationship to the perpetrator; time interval between injury and death; and the initial history given as to the cause of the injury. The cause of death fell into nine categories, the number one category being head trauma. Forty-five percent of the homicides were by head trauma, 12% by abdominal or body trauma, 25% by asphyxia (with half of these due to drowning), 10% by carbon monoxide poisoning or thermal injury, and the remaining 8% involving cases of neglect, stabbing, and poisoning. The majority of the homicide victims were male (67%) and black (67%). Forty-six percent were < or =1 year of age. Approximately 25% of the homicide cases were designated as shaken baby syndrome (SBS). In 97% of the cases, the assailant was known to the victim and was a family relative in 77%. Sixty-three percent of the assailants were female and 45% of the assailants were male; in 12%, the assailants were both parents, and in 1 case, the assailant remains unknown. Of the asphyxia deaths, 87% of the assailants were female. The time interval between injury and death ranged from minutes to hours in most cases to months in cases of repeated abuse and chronic injury and sequelae. The time interval between injury and the onset of symptoms remains unknown in most cases due to inconsistencies in the history and lack of credibility of the caretaker. The most common initial history given was "a fall" (20%). We report our findings of a decade of pediatric homicides to increase awareness of the common scenarios and case histories, demographics of the victims, causes of death, and perpetrators of pediatric homicide.     

Obesity,Body Mass Index,and Homicide

The body mass indexes (BMIs) of 100 randomly selected homicide cases from the files of Forensic Science SA were compared to the Australian and South Australian populations. There were 70 males and 30 females (M:F = 2.3:1; age range 18–84 years; mean 42.3 years). There was a substantially lower proportion of obese individuals in the homicide population compared to the general Australian and South Australian populations (19% [vs.] 27.9% and 30%, respectively). A second group of 144 randomly selected autopsy cases where the BMI was ≥40 kg/m² was analyzed. There were 77 males and 67 females (M:F = 1.2:1; age range 23–78 years; mean 46.7 years). The majority of deaths were natural (N = 108), with no homicides. A negative association between obesity and homicide has, therefore, been demonstrated. Reasons for the lower numbers of obese/morbidly obese individuals among homicide victims are unclear, but may include physical protection afforded by fat padding from sharp force injuries, and relative sociodemographic isolation.     

Homicide by sharp force in two Scandinavian capitals

In the Oslo and Copenhagen capital areas, 141 homicides by sharp force were committed in the ten-year period 1985-1994. This method accounted for 33% of the homicides in this period. Thirty-five percent of the victims were female, and most of the victims were between 20 and 50 years of age. The majority of the male victims were killed by an acquaintance, the females by their spouse. Sixty-five percent of the male and 37% of the female victims had alcohol in their blood. The majority of the female victims had lesions in 3-4 anatomical regions, while the males most often had lesions in only one anatomical region. Seventy-nine percent of the females and 36% of the males had self-defence injuries in the upper extremities. In 21 cases (15%) the offender was a woman, 19 of their victims being male; the weapon in these cases was most often a kitchen knife. Seventy-eight percent of the females and 49% of the males were killed in their own home. The most common circumstance was family row when the victim was female, while a fight was the most common circumstance when the victim was male. Three offenders committed suicide after having committed homicide(s) (seven victims; three offenders).     

Medicolegal Characteristics of Firearm Homicides in Belgrade,Serbia: Before,During, and After the War in the Former Yugoslavia

A comparative analysis of firearm homicides committed in Belgrade was performed including four representative years: 1987 (before the civil war in the Former Yugoslavia), 1991 (beginning of the war), 1997 (end of the war), and 2007 (period of social stabilization). The increase in the number of homicides was established in 1991 and 1997 compared with 1987, with the decrease in 2007, but with the continuous increase in the percentage of firearm homicides in the total number of homicides, from 12% in 1987 up to 56% in 2007. The significant increase in firearm homicides during the last decade of the 20th century can be explained by the social disturbances and the high availability of firearms, while their reduction in 2007 could be linked to the gradual stabilization of social circumstances. The results showed that the actual social, political, and economical changes strongly influenced medicolegal characteristics of homicides and particularly firearm homicides.