Non-fatal Strangulation is an Important Risk Factor for Homicide of Women

The purpose of this study was to examine non-fatal strangulation by an intimate partner as a risk factor for major assault, or attempted or completed homicide of women. A case control design was used to describe non-fatal strangulation among complete homicides and attempted homicides (n = 506) and abused controls (n = 427). Interviews of proxy respondents and survivors of attempted homicides were compared with data from abused controls. Data were derived using the Danger Assessment. Non-fatal strangulation was reported in 10% of abused controls, 45% of attempted homicides, and 43% of homicides. Prior non-fatal strangulation was associated with greater than six-fold odds (odds ratio [OR] 6.70, 95% confidence interval [CI] 3.91-11.49) of becoming an attempted homicide, and over seven-fold odds (OR 7.48, 95% CI 4.53-12.35) of becoming a completed homicide. These results show non-fatal strangulation as an important risk factor for homicide of women, underscoring the need to screen for non-fatal strangulation when assessing abused women in emergency department settings.