Petechiae in non-fatal strangulation: Prevalence, predictors and time-dependent detectability in forensic assessment
Petechiae are a key yet inconsistently observed finding following non-fatal strangulation, and their detection is influenced by both anatomical location and time since the event. This variability complicates forensic evaluation. This retrospective cohort study analysed 541 adult cases assessed at th...
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| Vydané v: | Forensic science international Ročník 378; s. 112730 |
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| Hlavní autori: | , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Elsevier B.V
01.02.2026
Elsevier Limited |
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| ISSN: | 0379-0738, 1872-6283, 1872-6283 |
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| Abstract | Petechiae are a key yet inconsistently observed finding following non-fatal strangulation, and their detection is influenced by both anatomical location and time since the event. This variability complicates forensic evaluation. This retrospective cohort study analysed 541 adult cases assessed at the Violence Protection Ambulatory of Charité Berlin between 2017 and 2023. The presence of petechiae was evaluated according to location and time interval to examination. Associations with clinical symptoms and external signs were examined using logistic regression, generalised estimating equations, and receiver operating characteristic (ROC) analysis. Petechiae were observed in 10 % of cases (54/541) and were significantly associated with shorter intervals between the event and examination (mean: 26 h vs. 61 h, p < 0.001), with a cut-off of 41.5 h (AUC 0.73 (95 % CI 0.6739–0.7953)). Early detectability was most common in the conjunctiva, while petechiae in the posterior ear region persisted longer (OR = 27.65). Clinical symptoms such as dyspnoea, hoarseness, and dysphagia were also associated with the presence of petechiae. A two-item risk score combining dyspnoea and absence of external skin findings achieved an AUC of 0.72. These findings suggest that petechiae are both time- and site-dependent and that clinical symptoms and external signs may support early identification. The proposed score provides a practical tool to aid forensic assessment in cases of suspected strangulation.
•Petechiae are key but time-sensitive markers of non-fatal strangulation injuries.•Early forensic exams increase petechiae detection, aiding accurate strangulation diagnosis.•Dyspnoea and skin injuries strongly predict petechiae presence in strangulation cases.•Women, especially young adults, represent the majority of strangulation and petechiae cases.•Developed risk score supports structured strangulation assessment and early detection. |
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| AbstractList | Petechiae are a key yet inconsistently observed finding following non-fatal strangulation, and their detection is influenced by both anatomical location and time since the event. This variability complicates forensic evaluation. This retrospective cohort study analysed 541 adult cases assessed at the Violence Protection Ambulatory of Charité Berlin between 2017 and 2023. The presence of petechiae was evaluated according to location and time interval to examination. Associations with clinical symptoms and external signs were examined using logistic regression, generalised estimating equations, and receiver operating characteristic (ROC) analysis. Petechiae were observed in 10 % of cases (54/541) and were significantly associated with shorter intervals between the event and examination (mean: 26 h vs. 61 h, p < 0.001), with a cut-off of 41.5 h (AUC 0.73 (95 % CI 0.6739–0.7953)). Early detectability was most common in the conjunctiva, while petechiae in the posterior ear region persisted longer (OR = 27.65). Clinical symptoms such as dyspnoea, hoarseness, and dysphagia were also associated with the presence of petechiae. A two-item risk score combining dyspnoea and absence of external skin findings achieved an AUC of 0.72. These findings suggest that petechiae are both time- and site-dependent and that clinical symptoms and external signs may support early identification. The proposed score provides a practical tool to aid forensic assessment in cases of suspected strangulation.
•Petechiae are key but time-sensitive markers of non-fatal strangulation injuries.•Early forensic exams increase petechiae detection, aiding accurate strangulation diagnosis.•Dyspnoea and skin injuries strongly predict petechiae presence in strangulation cases.•Women, especially young adults, represent the majority of strangulation and petechiae cases.•Developed risk score supports structured strangulation assessment and early detection. Petechiae are a key yet inconsistently observed finding following non-fatal strangulation, and their detection is influenced by both anatomical location and time since the event. This variability complicates forensic evaluation. This retrospective cohort study analysed 541 adult cases assessed at the Violence Protection Ambulatory of Charité Berlin between 2017 and 2023. The presence of petechiae was evaluated according to location and time interval to examination. Associations with clinical symptoms and external signs were examined using logistic regression, generalised estimating equations, and receiver operating characteristic (ROC) analysis. Petechiae were observed in 10 % of cases (54/541) and were significantly associated with shorter intervals between the event and examination (mean: 26 h vs. 61 h, p < 0.001), with a cut-off of 41.5 h (AUC 0.73 (95 % CI 0.6739-0.7953)). Early detectability was most common in the conjunctiva, while petechiae in the posterior ear region persisted longer (OR = 27.65). Clinical symptoms such as dyspnoea, hoarseness, and dysphagia were also associated with the presence of petechiae. A two-item risk score combining dyspnoea and absence of external skin findings achieved an AUC of 0.72. These findings suggest that petechiae are both time- and site-dependent and that clinical symptoms and external signs may support early identification. The proposed score provides a practical tool to aid forensic assessment in cases of suspected strangulation.Petechiae are a key yet inconsistently observed finding following non-fatal strangulation, and their detection is influenced by both anatomical location and time since the event. This variability complicates forensic evaluation. This retrospective cohort study analysed 541 adult cases assessed at the Violence Protection Ambulatory of Charité Berlin between 2017 and 2023. The presence of petechiae was evaluated according to location and time interval to examination. Associations with clinical symptoms and external signs were examined using logistic regression, generalised estimating equations, and receiver operating characteristic (ROC) analysis. Petechiae were observed in 10 % of cases (54/541) and were significantly associated with shorter intervals between the event and examination (mean: 26 h vs. 61 h, p < 0.001), with a cut-off of 41.5 h (AUC 0.73 (95 % CI 0.6739-0.7953)). Early detectability was most common in the conjunctiva, while petechiae in the posterior ear region persisted longer (OR = 27.65). Clinical symptoms such as dyspnoea, hoarseness, and dysphagia were also associated with the presence of petechiae. A two-item risk score combining dyspnoea and absence of external skin findings achieved an AUC of 0.72. These findings suggest that petechiae are both time- and site-dependent and that clinical symptoms and external signs may support early identification. The proposed score provides a practical tool to aid forensic assessment in cases of suspected strangulation. Petechiae are a key yet inconsistently observed finding following non-fatal strangulation, and their detection is influenced by both anatomical location and time since the event. This variability complicates forensic evaluation. This retrospective cohort study analysed 541 adult cases assessed at the Violence Protection Ambulatory of Charité Berlin between 2017 and 2023. The presence of petechiae was evaluated according to location and time interval to examination. Associations with clinical symptoms and external signs were examined using logistic regression, generalised estimating equations, and receiver operating characteristic (ROC) analysis. Petechiae were observed in 10 % of cases (54/541) and were significantly associated with shorter intervals between the event and examination (mean: 26 h vs. 61 h, p < 0.001), with a cut-off of 41.5 h (AUC 0.73 (95 % CI 0.6739-0.7953)). Early detectability was most common in the conjunctiva, while petechiae in the posterior ear region persisted longer (OR = 27.65). Clinical symptoms such as dyspnoea, hoarseness, and dysphagia were also associated with the presence of petechiae. A two-item risk score combining dyspnoea and absence of external skin findings achieved an AUC of 0.72. These findings suggest that petechiae are both time- and site-dependent and that clinical symptoms and external signs may support early identification. The proposed score provides a practical tool to aid forensic assessment in cases of suspected strangulation. Petechiae are a key yet inconsistently observed finding following non-fatal strangulation, and their detection is influenced by both anatomical location and time since the event. This variability complicates forensic evaluation. This retrospective cohort study analysed 541 adult cases assessed at the Violence Protection Ambulatory of Charité Berlin between 2017 and 2023. The presence of petechiae was evaluated according to location and time interval to examination. Associations with clinical symptoms and external signs were examined using logistic regression, generalised estimating equations, and receiver operating characteristic (ROC) analysis. Petechiae were observed in 10 % of cases (54/541) and were significantly associated with shorter intervals between the event and examination (mean: 26 h vs. 61 h, p < 0.001), with a cut-off of 41.5 h (AUC 0.73 (95 % CI 0.6739–0.7953)). Early detectability was most common in the conjunctiva, while petechiae in the posterior ear region persisted longer (OR = 27.65). Clinical symptoms such as dyspnoea, hoarseness, and dysphagia were also associated with the presence of petechiae. A two-item risk score combining dyspnoea and absence of external skin findings achieved an AUC of 0.72. These findings suggest that petechiae are both time- and site-dependent and that clinical symptoms and external signs may support early identification. The proposed score provides a practical tool to aid forensic assessment in cases of suspected strangulation. |
| ArticleNumber | 112730 |
| Author | Babigian, Julia Berti, Luca Oesterhelweg, Lars Amadasi, Alberto |
| Author_xml | – sequence: 1 givenname: Julia surname: Babigian fullname: Babigian, Julia organization: Institute of Legal Medicine and Forensic Sciences, Violence Protection Ambulatory, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin 10559, Germany – sequence: 2 givenname: Luca surname: Berti fullname: Berti, Luca organization: Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 49, Bologna 40126, Italy – sequence: 3 givenname: Lars surname: Oesterhelweg fullname: Oesterhelweg, Lars organization: Institute of Legal Medicine and Forensic Sciences, Violence Protection Ambulatory, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin 10559, Germany – sequence: 4 givenname: Alberto orcidid: 0000-0002-8920-6771 surname: Amadasi fullname: Amadasi, Alberto email: albertoamadasi@libero.it organization: Institute of Legal Medicine and Forensic Sciences, Violence Protection Ambulatory, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin 10559, Germany |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/41270566$$D View this record in MEDLINE/PubMed |
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| Keywords | Risk score Clinical symptoms Time-dependent detectability Petechiae Forensic evaluation Non-fatal strangulation |
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| References | Glass, Laughon, Campbell, Block, Hanson, Sharps (bib3) 2008; 35 Kondo, Betz, Eisenmenger (bib17) 1997; 110 Anscombe, Knight (bib7) 1996; 78 Shields, Corey, Weakley-Jones, Stewart (bib2) 2010; 31 Spungen, Bryan, Sachs, Wheeler (bib12) 2022; 23 Monahan, Bannon, Dams-O’Connor (bib8) 2022; 37 Härm, Rajs (bib15) 1981; 18 McClane, Strack, Hawley (bib9) 2001; 21 Olbrycht (bib6) 1964; 54 De Boos (bib1) 2019; 31 Prokop, Wabnitz (bib14) 1970; 67 Ely, Hirsch (bib13) 2000; 45 Brinkmann, Koops, Wischhusen, Kleiber (bib4) 1981; 87 Plattner, Bolliger, Zollinger (bib16) 2005; 153 Esser (bib5) 1933; 20 Sharman, Fitzgerald, Douglas (bib10) 2023; 13 McClane, Strack, Hawley (bib19) 2001; 21 Wilbur, Higley, Hatfield, Surprenant, Taliaferro, Smith, Jr (bib20) 2001; 21 Petreca, Burgess, Jarvis (bib21) 2023; 98 Parekh, Brkic, McMinn (bib11) 2025; 110 Pritchard, Reckdenwald, Nordham, Holton (bib18) 2018; 13 Plattner (10.1016/j.forsciint.2025.112730_bib16) 2005; 153 Petreca (10.1016/j.forsciint.2025.112730_bib21) 2023; 98 Glass (10.1016/j.forsciint.2025.112730_bib3) 2008; 35 Monahan (10.1016/j.forsciint.2025.112730_bib8) 2022; 37 McClane (10.1016/j.forsciint.2025.112730_bib19) 2001; 21 Kondo (10.1016/j.forsciint.2025.112730_bib17) 1997; 110 Wilbur (10.1016/j.forsciint.2025.112730_bib20) 2001; 21 Härm (10.1016/j.forsciint.2025.112730_bib15) 1981; 18 McClane (10.1016/j.forsciint.2025.112730_bib9) 2001; 21 Spungen (10.1016/j.forsciint.2025.112730_bib12) 2022; 23 Olbrycht (10.1016/j.forsciint.2025.112730_bib6) 1964; 54 Parekh (10.1016/j.forsciint.2025.112730_bib11) 2025; 110 Esser (10.1016/j.forsciint.2025.112730_bib5) 1933; 20 Shields (10.1016/j.forsciint.2025.112730_bib2) 2010; 31 Anscombe (10.1016/j.forsciint.2025.112730_bib7) 1996; 78 Sharman (10.1016/j.forsciint.2025.112730_bib10) 2023; 13 De Boos (10.1016/j.forsciint.2025.112730_bib1) 2019; 31 Prokop (10.1016/j.forsciint.2025.112730_bib14) 1970; 67 Brinkmann (10.1016/j.forsciint.2025.112730_bib4) 1981; 87 Ely (10.1016/j.forsciint.2025.112730_bib13) 2000; 45 Pritchard (10.1016/j.forsciint.2025.112730_bib18) 2018; 13 |
| References_xml | – volume: 110 start-page: 204 year: 1997 end-page: 207 ident: bib17 article-title: Retrospective study on skin reddenings and petechiae in the eyelids and the conjunctivae in forensic physical examinations publication-title: Int J. Leg. Med – volume: 21 start-page: 311 year: 2001 end-page: 315 ident: bib19 article-title: A review of 300 attempted strangulation cases Part II: clinical evaluation of the surviving victim publication-title: J. Emerg. Med – volume: 45 start-page: 1274 year: 2000 end-page: 1277 ident: bib13 article-title: Asphyxial deaths and petechiae: a review publication-title: J. Forensic Sci. – volume: 37 start-page: 75 year: 2022 end-page: 86 ident: bib8 article-title: Nonfatal strangulation (NFS) and intimate partner violence: a brief overview publication-title: J. Fam. Violence – volume: 35 start-page: 329 year: 2008 end-page: 335 ident: bib3 article-title: Non-fatal strangulation is an important risk factor for homicide of women publication-title: J. Emerg. Med. – volume: 54 start-page: 407 year: 1964 end-page: 423 ident: bib6 article-title: Beiträge zur Lehre über den Tod durch Erhängen publication-title: Dtsch Z. Gesamt Gericht Med – volume: 21 start-page: 311 year: 2001 end-page: 315 ident: bib9 article-title: A review of 300 attempted strangulation cases. Part II: clinical evaluation of the surviving victim publication-title: J. Emerg. Med – volume: 31 start-page: 320 year: 2010 end-page: 325 ident: bib2 article-title: Living victims of strangulation: a 10-year review of cases in a metropolitan community publication-title: Am. J. Forensic Med. Pathol. – volume: 87 start-page: 59 year: 1981 end-page: 73 ident: bib4 article-title: Compression of the neck and arterial obstruction (author’s transl) publication-title: Z. Recht – volume: 13 start-page: 160 year: 2018 end-page: 181 ident: bib18 article-title: Improving identification of strangulation injuries in domestic violence: Pilot data from a researcher–practitioner collaboration publication-title: Fem. Criminol. – volume: 31 start-page: 302 year: 2019 end-page: 308 ident: bib1 article-title: Non-fatal strangulation: Hidden injuries, hidden risks publication-title: Emerg. Med. Austral – volume: 20 start-page: 361 year: 1933 end-page: 375 ident: bib5 article-title: Zur Frage des Erwürgens ohne lokale anatomische Spuren beim Menschen und im Tierversuch publication-title: Dtsch Z. Gesamt Gericht Med – volume: 18 start-page: 101 year: 1981 end-page: 123 ident: bib15 article-title: Types of injuries and interrelated conditions of victims and assailants in attempted and homicidal strangulation publication-title: Forensic Sci. Int – volume: 23 start-page: 268 year: 2022 end-page: 275 ident: bib12 article-title: Symptoms and physical exam findings in sexual assault-related non-fatal strangulation publication-title: West. J. Emerg. Med. – volume: 67 start-page: 249 year: 1970 end-page: 257 ident: bib14 article-title: Vorkommen von Bindehautblutungen bei Lebenden und Toten, dargestellt in 10 Tabellen publication-title: Z. Recht – volume: 110 year: 2025 ident: bib11 article-title: Informing therapeutic care and legal process in assault cases involving non-fatal strangulation publication-title: J. Forensic Leg. Med – volume: 21 start-page: 297 year: 2001 end-page: 302 ident: bib20 article-title: Survey results of women who have been strangled while in an abusive relationship publication-title: J. Emerg. Med – volume: 98 year: 2023 ident: bib21 article-title: Manual and instrument asphyxiation/strangulation: examining perpetrator and victim characteristics publication-title: J. Forensic Leg. Med. – volume: 153 start-page: 202 year: 2005 end-page: 207 ident: bib16 article-title: Forensic assessment of survived strangulation publication-title: Forensic Sci. Int – volume: 78 start-page: 193 year: 1996 end-page: 197 ident: bib7 article-title: Delayed death after pressure on the neck: possible causal mechanisms and implications for mode of death in manual strangulation publication-title: Forensic Sci. Int – volume: 13 year: 2023 ident: bib10 article-title: Medical evidence assisting non-fatal strangulation prosecution: a scoping review publication-title: BMJ Open – volume: 45 start-page: 1274 issue: 6 year: 2000 ident: 10.1016/j.forsciint.2025.112730_bib13 article-title: Asphyxial deaths and petechiae: a review publication-title: J. Forensic Sci. doi: 10.1520/JFS14878J – volume: 153 start-page: 202 issue: 2–3 year: 2005 ident: 10.1016/j.forsciint.2025.112730_bib16 article-title: Forensic assessment of survived strangulation publication-title: Forensic Sci. Int doi: 10.1016/j.forsciint.2004.09.106 – volume: 18 start-page: 101 issue: 2 year: 1981 ident: 10.1016/j.forsciint.2025.112730_bib15 article-title: Types of injuries and interrelated conditions of victims and assailants in attempted and homicidal strangulation publication-title: Forensic Sci. Int doi: 10.1016/0379-0738(81)90148-1 – volume: 13 start-page: 160 issue: 2 year: 2018 ident: 10.1016/j.forsciint.2025.112730_bib18 article-title: Improving identification of strangulation injuries in domestic violence: Pilot data from a researcher–practitioner collaboration publication-title: Fem. Criminol. doi: 10.1177/1557085116653181 – volume: 98 year: 2023 ident: 10.1016/j.forsciint.2025.112730_bib21 article-title: Manual and instrument asphyxiation/strangulation: examining perpetrator and victim characteristics publication-title: J. Forensic Leg. Med. doi: 10.1016/j.jflm.2023.102575 – volume: 35 start-page: 329 issue: 3 year: 2008 ident: 10.1016/j.forsciint.2025.112730_bib3 article-title: Non-fatal strangulation is an important risk factor for homicide of women publication-title: J. Emerg. Med. doi: 10.1016/j.jemermed.2007.02.065 – volume: 110 start-page: 204 issue: 4 year: 1997 ident: 10.1016/j.forsciint.2025.112730_bib17 article-title: Retrospective study on skin reddenings and petechiae in the eyelids and the conjunctivae in forensic physical examinations publication-title: Int J. Leg. Med doi: 10.1007/s004140050068 – volume: 87 start-page: 59 issue: 1–2 year: 1981 ident: 10.1016/j.forsciint.2025.112730_bib4 article-title: Compression of the neck and arterial obstruction (author’s transl) publication-title: Z. Recht – volume: 78 start-page: 193 issue: 3 year: 1996 ident: 10.1016/j.forsciint.2025.112730_bib7 article-title: Delayed death after pressure on the neck: possible causal mechanisms and implications for mode of death in manual strangulation publication-title: Forensic Sci. Int doi: 10.1016/0379-0738(95)01886-7 – volume: 21 start-page: 311 issue: 3 year: 2001 ident: 10.1016/j.forsciint.2025.112730_bib19 article-title: A review of 300 attempted strangulation cases Part II: clinical evaluation of the surviving victim publication-title: J. Emerg. Med doi: 10.1016/S0736-4679(01)00400-0 – volume: 31 start-page: 320 issue: 4 year: 2010 ident: 10.1016/j.forsciint.2025.112730_bib2 article-title: Living victims of strangulation: a 10-year review of cases in a metropolitan community publication-title: Am. J. Forensic Med. Pathol. doi: 10.1097/PAF.0b013e3181d3dc02 – volume: 37 start-page: 75 issue: 1 year: 2022 ident: 10.1016/j.forsciint.2025.112730_bib8 article-title: Nonfatal strangulation (NFS) and intimate partner violence: a brief overview publication-title: J. Fam. Violence doi: 10.1007/s10896-020-00208-7 – volume: 13 issue: 3 year: 2023 ident: 10.1016/j.forsciint.2025.112730_bib10 article-title: Medical evidence assisting non-fatal strangulation prosecution: a scoping review publication-title: BMJ Open doi: 10.1136/bmjopen-2023-072077 – volume: 110 year: 2025 ident: 10.1016/j.forsciint.2025.112730_bib11 article-title: Informing therapeutic care and legal process in assault cases involving non-fatal strangulation publication-title: J. Forensic Leg. Med doi: 10.1016/j.jflm.2025.102826 – volume: 21 start-page: 297 issue: 3 year: 2001 ident: 10.1016/j.forsciint.2025.112730_bib20 article-title: Survey results of women who have been strangled while in an abusive relationship publication-title: J. Emerg. Med doi: 10.1016/S0736-4679(01)00398-5 – volume: 21 start-page: 311 issue: 3 year: 2001 ident: 10.1016/j.forsciint.2025.112730_bib9 article-title: A review of 300 attempted strangulation cases. Part II: clinical evaluation of the surviving victim publication-title: J. Emerg. Med doi: 10.1016/S0736-4679(01)00400-0 – volume: 54 start-page: 407 issue: 4 year: 1964 ident: 10.1016/j.forsciint.2025.112730_bib6 article-title: Beiträge zur Lehre über den Tod durch Erhängen publication-title: Dtsch Z. Gesamt Gericht Med – volume: 20 start-page: 361 issue: 1 year: 1933 ident: 10.1016/j.forsciint.2025.112730_bib5 article-title: Zur Frage des Erwürgens ohne lokale anatomische Spuren beim Menschen und im Tierversuch publication-title: Dtsch Z. Gesamt Gericht Med – volume: 67 start-page: 249 issue: 4 year: 1970 ident: 10.1016/j.forsciint.2025.112730_bib14 article-title: Vorkommen von Bindehautblutungen bei Lebenden und Toten, dargestellt in 10 Tabellen publication-title: Z. Recht doi: 10.1007/BF02053748 – volume: 31 start-page: 302 issue: 3 year: 2019 ident: 10.1016/j.forsciint.2025.112730_bib1 article-title: Non-fatal strangulation: Hidden injuries, hidden risks publication-title: Emerg. Med. Austral doi: 10.1111/1742-6723.13243 – volume: 23 start-page: 268 issue: 2 year: 2022 ident: 10.1016/j.forsciint.2025.112730_bib12 article-title: Symptoms and physical exam findings in sexual assault-related non-fatal strangulation publication-title: West. J. Emerg. Med. doi: 10.5811/westjem.2021.2.50919 |
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| Title | Petechiae in non-fatal strangulation: Prevalence, predictors and time-dependent detectability in forensic assessment |
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