[Evaluating the functional impairment of assault survivors in a judicial context: frequency of aggravating factors according to the French Penal Code and evidence for heterogeneous medical practice].

Objectives: In cases of assault and battery, the French Penal Code considers some aggravating factors. No data are available on the frequency of aggravating factors. Our main objective was to determine this frequency. A secondary objective was to present the evaluation in several forensic medicine units of the duration of the victims' inability to fulfil their usual daily activities, in days of "Total incapacity to work" (TIW).

Methods: Data were collected from six forensic medicine units on 300 evaluations of assaults survivors: aggravating factors, characteristics of the victims and of the assaults, results of medical examination, and determinants of TIW.

Results: Aggravating factors were present in most cases (232 of 300, 77%). Median duration of TIW was 2 days (range: 0-60). Medical evaluation ended in the absence of TIW in 0 to 56% of cases in the 6 units (Chi(2), P<0.0001). Forensic physicians considered that they had not evaluated the victims' mental state in 63 of 300 cases (21%). This rate varied significantly from one unit to another (P<0.0001). Determinants of TIW were primarily traumatic injuries in 45% of cases and functional impairment in 55%. Such proportions varied from one unit to another (P=0.01). Mental state impairment was the main determinant of TIW in 0 to 23% of cases (P=0.009).

Discussion: The present study documented the high frequency of aggravating factors and the heterogeneity of forensic evaluation in cases of assault and battery. Identifying determinants of TIW in everyday practice can participate in the development of national guidelines.