Review| Volume 53, ISSUE 10, P3078-3087, October 2022

Repeat assault injuries: A scoping review of the incidence and associated risk factors


      • Repeat assault is a significant public health issue.
      • Youth, racialized and marginalized groups, and those with mental health concerns or contact with the criminal justice system were most at-risk for repeat assault.
      • Our findings suggest that early intervention targeted to at-risk groups will be important in developing effective prevention strategies.



      Individuals who experience assault are at high risk of being re-assaulted. Our objective was to identify reported incidences of re-assault and associated risk factors to better inform prevention strategies.


      We conducted a scoping review and searched databases (MEDLINE, PsychINFO, CINAHL, Cochrane Reviews, and Scopus) and grey literature. We performed abstract and full-text screening, and abstracted incidence of re-assault and information related to age, sex, socioeconomic status, mental illness, and incarceration.


      We included 32 articles. Studies varied based on setting where index assaults were captured (n=18 inpatient only, n=13 emergency department or inpatient, n=1 other). Reported incidences ranged from 0.8% over one month to 62% through the lifetime. Important risk factors identified include young age, low socioeconomic status, racialized groups, history of mental illness or substance use disorder, and history of incarceration.


      Rates of re-assault are high and early intervention is necessary for prevention. We identified notable risk factors that require further in-depth analysis, including sex, gender and age-stratified analyses.

      Policy implications

      Key risk factors identified should inform timely and targeted intervention strategies for prevention.


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        • Kaske S
        • Lefering R
        • Trentzsch H
        • Driessen A
        • Bouillon B
        • Maegele M
        • et al.
        Quality of life two years after severe trauma: a single-centre evaluation.
        Injury. 2014; 45 (Suppl): S100-S105
        • Vella MA
        • Warshauer A
        • Tortorello G
        • Fernandez-Moure J
        • Giacolone J
        • Chen B
        • et al.
        Long-term functional, psychological, emotional, and social outcomes in survivors of firearm injuries.
        JAMA Surg. 2019;
      1. World Health Organization. Homicide: WHO global health estimates (2015 update) 2017 [Available from:

      2. Centers for Disease Control and Prevention. Web-based injury statistics query and reporting system 2022 [Available from:

        • Rowhani-Rahbar A
        • Zatzick D
        • Wang J
        • Mills BM
        • Simonetti JA
        • Fan MD
        • et al.
        Firearm-related hospitalization and risk for subsequent violent injury, death, or crime perpetration: a cohort study.
        Ann Intern Med. 2015; 162: 492-500
      3. JBI Reviewer's Manual: Joanna Briggs Institute; 2019 [Available from:

      4. Krug E, Dahlberg L, Mercy J, Zwi A, Lozano R. World report on violence and health. Geneva; 2002.

      5. National Heart L, and blood institute study quality assessment tools 2020 [Available from:

        • Jacob B
        • Cullen N
        • Haag HL
        • Chan V
        • Stock D
        • Colantonio A.
        Assault by strangulation: sex differences in patient profile and subsequent readmissions.
        Can J Public Health. 2020; 111: 492-501
        • Kwan K
        • Wiebe D
        • Cerdá M
        • Goldman-Mellor S.
        Repeat assault injury among adolescents utilizing emergency care: a statewide longitudinal study.
        J Emerg Med. 2019; 57: 254-262
        • Kao AM
        • Schlosser KA
        • Arnold MR
        • Kasten KR
        • Colavita PD
        • Davis BR
        • et al.
        Trauma recidivism and mortality following violent injuries in young adults.
        J Surg Res. 2019; 237: 140-147
        • Oleck NC
        • Liu FC
        • Halsey JN
        • Lee ES
        • Granick MS.
        Violence against women: facial fractures secondary to assault in the urban female population.
        Am Surg. 2018; 84: e254-e2e6
        • Kaufman E
        • Rising K
        • Wiebe DJ
        • Ebler DJ
        • Crandall ML
        • Delgado MK.
        Recurrent violent injury: magnitude, risk factors, and opportunities for intervention from a statewide analysis.
        Am J Emerg Med. 2016; 34: 1823-1830
        • Carter PM
        • Walton MA
        • Roehler DR
        • Goldstick J
        • Zimmerman MA
        • Blow FC
        • et al.
        Firearm violence among high-risk emergency department youth after an assault injury.
        Pediatrics. 2015; 135: 805-815
        • VE Chong
        • Lee WS
        • Victorino GP.
        Neighborhood socioeconomic status is associated with violent reinjury.
        J Surg Res. 2015; 199: 177-182
        • Cunningham RM
        • Carter PM
        • Ranney M
        • Zimmerman MA
        • Blow FC
        • Booth BM
        • et al.
        Violent reinjury and mortality among youth seeking emergency department care for assault-related injury: a 2-year prospective cohort study.
        JAMA Pediatr. 2015; 169: 63-70
        • Nanney JT
        • Conrad EJ
        • McCloskey M
        • Constans JI.
        Criminal behavior and repeat violent trauma: a case–control study.
        Am J Prevent Med. 2015; 49: 395-401
        • Faergemann C
        • Lauritsen JM
        • Brink O
        • Stovring H.
        The epidemiology of repeat contacts with an emergency department or an institute of forensic medicine due to violent victimization in a Danish urban population.
        J Forensic Leg Med. 2007; 14: 333-339
        • KINGMA J.
        Repeat victimization of victims of violence: a retrospective study from a hospital emergency department for the period 1971-1995.
        J Interpers Violence. 1999; 14: 79-90
        • Moscovitz H
        • Degutis L
        • Bruno GR
        • Schriver J.
        Emergency department patients with assault injuries: previous injury and assault convictions.
        Ann Emerg Med. 1997; 29: 770-775
        • Schrøder HM
        • Petersen KK
        • Eiskjaer SP
        • Charles AV.
        Epidemiology of violence in a Danish municipality. Changes in the incidence during the 1980s.
        Dan Med Bull. 1992; 39: 81-83
        • Cortolillo N
        • Moeller E
        • Parreco J
        • Kimball J
        • Martinez R
        • Rattan R.
        Readmission and re-injury patterns in pediatric assault victims.
        Pediatr Surg Int. 2020; 36: 191-199
        • Foran C
        • Clark D
        • Inaba K
        • Schellenberg M
        • Wade NB
        • Demetriades D.
        Youth and young adult victims of interpersonal violence at LA county + USC Medical Center: a review of epidemiology and recidivism.
        Am Surg. 2019; 85: 1166-1170
        • Lim KHA
        • McDermott K
        • Read DJ.
        Interpersonal violence and violent re-injury in the Northern Territory.
        Aust J Rural Health. 2020; 28: 67-73
        • Buicko JL
        • Parreco J
        • Willobee BA
        • Wagenaar AE
        • Sola JE.
        Risk factors for nonelective 30-day readmission in pediatric assault victims.
        J Pediatr Surg. 2017; 52: 1628-1632
        • Nygaard RM
        • Marek AP
        • Daly SR
        • Van Camp JM.
        Violent trauma recidivism: Does all violence escalate?.
        Eur J Trauma Emerg Surg. 2018; 44: 851-858
        • Meuleners LB
        • Lee AH
        • Hendrie D.
        Interpersonal violence hospitalisations for adolescents: a population-based study.
        J Paediatr Child Health. 2010; 46: 686-690
        • Meuleners LB
        • Lee AH
        • Hendrie D
        • Fraser M.
        A population study on indigenous hospitalisations for interpersonal violence.
        Aust Health Rev. 2010; 34: 123-126
        • Gallagher CA.
        Injury recurrence among untreated and medically treated victims of violence in the USA.
        Soc Sci Med. 2005; 60: 627-635
        • Cooper C
        • Eslinger D
        • Nash D
        • Zawahri J
        • Stolley P.
        Repeat victims of violence: report of a large concurrent case-control study.
        Arch Surg. 2000; 135: 837-843
        • Conti CT
        • Moncure M
        • Hines J
        • Clack Z
        • Smith T
        • Simpkins CO
        Measurement of self-esteem in repeat assault victims.
        J Natl Med Assoc. 1998; 90: 171-175
        • Buss TF
        • Abdu R.
        Repeat victims of violence in an urban trauma center.
        Violence Vict. 1995; 10: 183-194
        • Poole GV
        • Griswold JA
        • Thaggard VK
        • Rhodes RS.
        Trauma is a recurrent disease.
        Surgery. 1993; 113: 608-611
        • Worrell SS
        • Koepsell TD
        • Sabath DR
        • Gentilello LM
        • Mock CN
        • Nathens AB.
        The risk of reinjury in relation to time since first injury: a retrospective population-based study.
        J Trauma. 2006; 60: 379-384
        • Goins WA
        • Thompson J
        • Simpkins C.
        Recurrent intentional injury.
        J Natl Med Assoc. 1992; 84: 431-435
        • Meuleners LB
        • Lee AH
        • Hendrie D.
        A population-based study of repeat hospital admissions due to interpersonal violence for children aged 0-9 years.
        Paediatr Perinat Epidemiol. 2009; 23: 239-244
        • Litacker D.
        Preventing recurring injuries from violence: the risk of assault among Cleveland youth after hospitalization.
        Am J Public Health. 1996; 86: 1633-1636
        • Tellez MG
        • Mackersie RC
        • Morabito D
        • Shagoury C
        • Heye C.
        Risks, costs, and the expected complication of re-injury.
        Am J Surg. 1995; 170 (discussion 4): 660-663
        • Meuleners LB
        • Hendrie D
        • Lee AH.
        Hospitalisations due to interpersonal violence: a population-based study in Western Australia.
        Med J Aust. 2008; 188: 572-575
        • Dowd MD
        • Langley J
        • Koepsell T
        • Soderberg R
        • Rivara FP.
        Hospitalizations for injury in New Zealand: prior injury as a risk factor for assaultive injury.
        Am J Public Health. 1996; 86: 929-934
        • Choi AW
        • Lo BC
        • Wong JY
        • Lo RT
        • Chau PC
        • Wong JK
        • et al.
        Clinical features of heterosexual intimate partner violence victims with escalating injury severity.
        J Interpers Violence. 2021; 36: 8585-8605
      6. World Health Organization. Global status report on violence prevention 2014. 2014.

        • Richardson JB
        • Wical W
        • Kottage N
        • Bullock C.
        Shook ones: understanding the intersection of nonfatal violent firearm injury, incarceration, and traumatic stress among young black men.
        Am J Men's Health. 2020; 14 (1557988320982181)
        • Wiebe DJ
        • Blackstone MM
        • Mollen CJ
        • Culyba AJ
        • Fein JA.
        Self-reported violence-related outcomes for adolescents within eight weeks of emergency department treatment for assault injury.
        J Adolesc Health. 2011; 49: 440-442
        • Snider C
        • Lee J.
        Youth violence secondary prevention initiatives in emergency departments: a systematic review.
        Cjem. 2009; 11: 161-168
        • Smith R
        • Dobbins S
        • Evans A
        • Balhotra K
        • Dicker RA.
        Hospital-based violence intervention: risk reduction resources that are essential for success.
        J Trauma Acute Care Surg. 2013; 74 (discussion 80-2): 976-980
        • Walker GN
        • Dekker AM
        • Hampton DA
        • Akhetuamhen A
        • Moore PQ
        A case for risk stratification in survivors of firearm and interpersonal violence in the urban environment.
        West J Emerg Med. 2020; 21: 132-140
        • Juillard C
        • Cooperman L
        • Allen I
        • Pirracchio R
        • Henderson T
        • Marquez R
        • et al.
        A decade of hospital-based violence intervention: Benefits and shortcomings.
        J Trauma Acute Care Surg. 2016; 81: 1156-1161