Risk of mortality by aggression: A retrospective cohort study in women with notification of interpersonal violence in Brazil

Abstract

Objectives

The present study investigated the incidence of mortality by aggression in women who experienced interpersonal violence. The study also aimed identify whether intimate partner violence (IPV) was associated with the risk of death by aggression.

Study design

This was a population-based retrospective cohort study linking data from the National Disease Notification System and the Mortality Information System.

Methods

The study population included women, aged 15–59 years, with notification of interpersonal violence in a 1-year period. Data were also collected on deaths by any cause within 2 years of notification of interpersonal violence in the study population. For survival analysis, this study used the following two approaches: (1) specific risk by aggression; and (2) the subdistribution of risks. In addition, the Cox and Fine-Gray models were used to verify if IPV was associated with the risk of death by aggression.

Results

This study identified 117,743 women, aged 15–59 years, with notification of interpersonal violence. In total, 818 of the study population died within 2 years of notification. The cumulative incidence at the end of 2 years was 0.003; thus, a mortality rate of approximately 300 deaths/100,000 women who had experienced interpersonal violence. In the two survival analysis approaches, IPV showed no significant association with death by aggression. Only the ‘Black and Others’ ethnic group was associated with death by aggression, with a 33 % increase in the death rate (hazard ratio [HR] 1.33; 95 % confidence interval [CI] 1.08–1.65).

Conclusion

The results of this study highlight the impact of ethnic group on the risk of death among women experiencing interpersonal violence. Intersectoral coordination strategies are required to promote early detection of violence and comprehensive care.