{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:58:15Z","timestamp":1790686695025,"version":"4.1.0"},"reference-count":46,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"unspecified","delay-in-days":271,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S193578932610456X_sec1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to describe the epidemiological, clinical, and operational characteristics of violence-related emergency medical services (EMS) encounters recorded on the Anatolian side of Istanbul from 2019 to 2023, to conduct secondary descriptive comparisons by sex, and to identify factors associated with confirmed prehospital death status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S193578932610456X_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational registry-based analysis of records coded as \u201cViolence &amp; Assault.\u201d Clinical, operational, and demographic variables were analyzed. Comparisons by sex and confirmed death status were conducted using nonparametric and categorical-data tests. In a secondary exploratory analysis, Firth-penalized multivariable logistic regression was used to estimate adjusted associations with confirmed prehospital death status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S193578932610456X_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sample comprised 29,335 violence-related EMS encounters; most involved young adult males and occurred in urban districts. Most recorded clinical findings were normal or preserved, although a small subgroup showed physiological instability. Several sex-based differences were statistically significant, but their effect sizes were generally small. Confirmed prehospital death was recorded in 132 encounters (0.45%). In the exploratory Firth model, severe respiratory status (aOR 56.02, 95% CI 8.62-364.05), altered consciousness (aOR 10.71, 95% CI 1.67-68.67), and cyanotic skin (aOR 4.24, 95% CI 2.67-6.73) were associated with the highest adjusted odds ratios for confirmed prehospital death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S193578932610456X_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Violence-related EMS encounters were concentrated among young adult males, and most did not meet the confirmed-death definition. Nevertheless, a clinically important subgroup presented with physiological instability. In the exploratory analysis, confirmed prehospital death was most strongly associated with acute physiological compromise; operational intervals should be interpreted cautiously as potential markers of case complexity and EMS workflow rather than as causal determinants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/dmp.2026.10456","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:21:06Z","timestamp":1790684466000},"source":"Crossref","is-referenced-by-count":0,"title":["Violence-Related Emergency Medical Services Encounters in the Anatolian Side of Istanbul: A Retrospective Registry-Based Study"],"prefix":"10.1017","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7823-0883","authenticated-orcid":false,"given":"M. Fevzi","family":"Esen","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03k7bde87","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tutku","family":"Tuncal\u0131 Yaman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02kswqa67","id-type":"ROR","asserted-by":"publisher"}],"name":"Marmara University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"S193578932610456X_r7","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2013-203133"},{"key":"S193578932610456X_r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2004.12.045"},{"key":"S193578932610456X_r24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296"},{"key":"S193578932610456X_r6","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2016-206081"},{"key":"S193578932610456X_r4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d3313"},{"key":"S193578932610456X_r14","unstructured":"14. Royal College of Emergency Medicine, College of Paramedics. Hospital Handover Delays for Patients in Ambulances: Options Appraisal to Reduce Harm. Royal College of Emergency Medicine; 2024. Accessed August 8, 2026. Available from: https:\/\/rcem.ac.uk\/wp-content\/uploads\/2024\/08\/Hospital_Handover_Delays_for_Patients_in_Ambulances_Options_Appraisal_to_Reduce_Harm_v1.pdf"},{"key":"S193578932610456X_r36","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2015.175"},{"key":"S193578932610456X_r45","volume-title":"T\u00fcrkiye\u2019de Kad\u0131na Y\u00f6nelik \u015eiddet Ara\u015ft\u0131rmas\u0131 Tamamland\u0131","year":"2025"},{"key":"S193578932610456X_r25","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-746"},{"key":"#cr-split#-S193578932610456X_r13.1","unstructured":"13. NHS England. 2024\/25 Priorities and Operational Planning Guidance. NHS"},{"key":"#cr-split#-S193578932610456X_r13.2","unstructured":"2024. Accessed August 8, 2026. 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NHS England. Reducing Hospital Handover Delays. NHS; 2026. Accessed August 8, 2026. 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