Strangulation victimization in the United States: Findings from a nationwide emergency department sample

Strangulation is a form of asphyxiation caused by the obstruction of blood and airflow through the neck and poses a significant threat to both immediate and lasting health outcomes in the United States (U.S.). This study examines data from 686,630,579 emergency department (ED) admissions across the U.S. between 2016 and 2020, drawn from the Nationwide Emergency Department Sample (NEDS), to evaluate the prevalence and demographic characteristics of strangulation-related visits. Among all ED admissions, 0.002% (n = 11,102) were attributed to strangulation. A disproportionate number of these cases involved females (n = 9533, 86%), with the highest incidence observed in women aged 20 to 24 years (20.94%) and in men aged 15 to 19 years (16.57%). Strangulation-related ED visits were more prevalent among individuals with Medicaid, those without insurance, or those using alternative payment methods compared to those with private insurance. Geographically, these visits were more common in the Midwest and West regions compared with the Northeast. This study discusses the implications of these findings in terms of both the consequences for victims and the opportunities for healthcare providers, law enforcement agencies, and policymakers to improve care and responses for this at-risk population.