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Introduction
There is substantial evidence in the scientific literature supporting the association between alcohol intoxication and a range of related harms, including assaults. 1-3 In a multinational study, the attributable risk of injury associated with alcohol use was highest in violence related injuries. 2 Injuries and hospitalisations due to assaults are therefore one of the important markers of the health burden of alcohol use in society.
A recent population based study in the state of Victoria, Australia reported an increase in the incidence of severe injury due to assaults between 2001 and 2007. 4 Fortunately most assaults do not result in major injury and this may skew the interpretation of injury trends. 5 In addition there may be significant regional and local variations in patterns of assault injury due to social factors such as drug abuse and alcohol consumption. 6 Sydney and the surrounding local government areas have a relatively high density of alcohol outlets and premises within the area. 7 In particular, the City of Sydney has the highest absolute number of 24-h liquor licences in Australia. 7
The present study was undertaken to: (1) describe long term incidence trends in hospital admissions due to assault within the direct catchment area of an inner city major trauma centre; and (2) examine the association between major trauma and clinical evidence of alcohol intoxication.
Methods
Setting
The Royal Prince Alfred Hospital (RPAH) is an inner city major trauma centre in Sydney, New South Wales. Sydney is Australia's most populous city with a population of around 5 million people. 7 A single data abstractor (SR) has collected data prospectively into the trauma registry since 1991. There were around 2500 trauma and injury related in-patient admissions a year to this institution, with only around 1-2% being for gun related penetrating trauma. Patients were included in the trauma registry if the primary diagnosis or reason for admission was an injury. Data were submitted to the New South Wales Institute of Trauma and Injury Management annually for external auditing purposes.
Study design
This was a retrospective study of patients identified from the RPAH Trauma Registry from 1 January 1999 to 31 December 2009. Inclusion criteria were patients aged 15 years and over with in-patient hospital admission due to an assault...