Epidemiological characteristics and predictors of surgical intervention in forensic sharp and penetrating injuries

Objective: This study aimed to analyze the epidemiological and clinical characteristics of forensic sharp and penetrating injuries andto identify independent predictors of surgical intervention in a tertiary trauma center.Patients and Methods: This retrospective cohort study included all patients presenting with forensic-reported sharp and penetratinginjuries to a level 1 trauma center between January 1 and December 31, 2024. Demographic characteristics, injury mechanisms,anatomical injury locations, vital signs, imaging use, and clinical outcomes were extracted from electronic health records. The primaryoutcome was the need for surgical intervention. Univariate and multivariate logistic regression analyses were performed to identifyindependent predictors of surgery.Results: A total of 1,076 patients were included, of whom 123 (11.4%) required surgical intervention. The cohort waspredominantly male (85.8%) with a median age of 30 years. Upper extremity trauma was the most common anatomical site(73.8%), particularly in self-inflicted cases. Hemodynamic instability at presentation was strongly associated with surgery(OR 10.70). Increasing age was independently associated with surgical intervention, with each additional year increasing theodds by approximately 3%. Male sex (OR 3.45) and foreign nationality (OR 3.69) were also independent predictors. Injuriesinvolving the head, maxillofacial, or neck region were associated with a lower likelihood of surgical management (OR 0.18).Conclusion: In this large, single-center cohort of forensic sharp and penetrating injuries, older age, male sex, foreign nationality, andhemodynamic instability at presentation emerged as key early predictors of surgical intervention, while head, maxillofacial, and neckinjuries were less likely to require operative management. These findings underscore the value of early clinical assessment and regionspecifictrauma data in supporting timely surgical decision-making, injury-prevention strategies, and local trauma system planning.