Fatal and Non-Fatal Strangulation in Sweden: What the Evidence Reveals
Organized by: International Forensic Scientist Awards
Website: forensicscientist.org
14th Edition of Forensic Scientist Awards 26-27 September 2025 | Mumbai, India
Strangulation is one of the most dangerous yet often overlooked forms of violence. It is closely linked to intimate partner violence (IPV) and sexual assault, with women being the primary victims. Unlike many other forms of assault, strangulation can leave very subtle signs, making it difficult to detect without a careful clinical and forensic examination.
A new retrospective study conducted in Sweden sheds light on the injury patterns and forensic implications of both fatal and non-fatal strangulation cases. The findings are critical not only for doctors and forensic experts but also for legal professionals working to protect victims and bring perpetrators to justice.
Why This Study Matters
Non-fatal strangulation (NFS) can serve as a warning sign of escalating violence, often preceding homicide. Fatal strangulation (FS), on the other hand, provides important forensic evidence that can determine the exact cause of death and the method used. By comparing both, researchers can better understand injury patterns, risk factors, and the role of intimate partner violence.
What the Study Looked At
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617 non-fatal strangulation cases (NFS) from 2022
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139 fatal strangulation cases (FS) from 2003–2022
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Data was collected from the Swedish National Board of Forensic Medicine
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Researchers used statistical analysis to compare strangulation methods and injury patterns
Key Findings
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Strangulation Methods
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In non-fatal cases, manual strangulation (using hands) was by far the most common (96%).
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In fatal cases, manual and ligature strangulation (using ropes, cords, or similar objects) were nearly equal.
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Injury Patterns
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Petechiae (tiny red or purple spots caused by bleeding under the skin) were found in 91% of fatal cases, but only in 4% of non-fatal cases.
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Fractures of neck structures were more common in older fatal strangulation victims, suggesting age as a factor in vulnerability.
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Context of Violence
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Intimate partner violence (IPV) was the leading context in both groups—67% in NFS cases and 43% in FS cases.
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The majority of victims were women, reflecting the gendered nature of this form of violence.
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What This Means for Forensic and Clinical Practice
The study highlights clear differences between fatal and non-fatal strangulation injuries, underscoring the need for:
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Thorough forensic investigations in all suspected cases
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Standardized documentation of injuries to support legal processes
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Clinical awareness that even when injuries appear minor, the risk of fatal escalation remains high
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Greater recognition of strangulation as a marker of severe intimate partner violence
Final Thoughts
Strangulation is not just another form of assault—it is often a silent predictor of lethal violence. This Swedish study demonstrates that both fatal and non-fatal cases carry distinct injury patterns, and that medical, forensic, and legal professionals must work closely to recognize, document, and act on these signs.
By improving awareness and documentation, we can support victims more effectively and strengthen the legal response against perpetrators, ultimately preventing future tragedies.
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