1638 Sexual assaults are extremely common among women. Surveys show that 44% of women have been victims of an actual or attempted sexual assault in their lifetimes. 1 A re- port by the American Medical Association on sexual as- sault states that one of every five women will be a victim by age 21 years. In addition, up to 50% of victims have re- ported assault on more than one occasion. 1 Prior case series report that 10% to 30% of women who are sexually assaulted file legal charges. 2-4 However, there are few studies evaluating the legal outcomes with assault characteristics; all such studies are case series only. Know- ing the characteristics of those assaults with successful legal outcomes may help to better evaluate and counsel those women undergoing examinations for alleged sex- ual assaults. To better describe assault victims who pursue legal action, we conducted a case-control study compar- ing demographic and assault characteristics in those women who had a legal outcome with those same charac- teristics in sexual-assault victims who did not have a legal outcome. Methods We reviewed the medical records of all female patients aged 15 years and older with reports of sexual assault at an urban emergency department between January 1997 and September 1999 (n = 888). 5 History of the assault event was by patient report as recorded by the emergency depart- ment social worker. After patient consent was obtained, in all cases, second- and third-year residents in obstetrics and gynecology who had received specific education in sexual assault evaluations performed the physical examination. Emergency department physicians performed additional evaluations and studies as warranted. The genital exami- nation was by conventional methods, and colposcopic pho- tographs were used only to document visible genital trauma. All patient histories, physical examination, and laboratory findings were recorded on a standardized form. When clinically indicated, immunochemistry and enzy- matic analyses were performed to determine the presence of alcohol or drugs. The detection limits for the following substances were cocaine 300 ng/mL, opiates 30 ng/mL, methadone 250 ng/mL, tricyclic antidepressants 1000 ng/mL, and ethanol 15 ng/mL. Enzymatic analysis of blood alcohol allowed a lower level of detection (5 ng/dL). Levels for “date-rape” drugs were evaluated in the forensic toxicology laboratory; however, access to that in- formation was not allowed. Data were collected from the standardized emergency department records and entered into a database. 2 Vari- ables collected included demographic characteristics of the victim, description of the assailant(s), assault descrip- From the Departments of Obstetrics and Gynecology a and Pediatrics, c University of Washington, and the Center for Health Training. c Presented at the Seventy-First Annual Meeting of the Pacific Coast Gyne- cological and Obstetrical Society, October 22-27, 2002, Rancho Mirage, Calif. Reprints not available from the authors. © 2003, Mosby, Inc. All rights reserved. 0002-9378/2003 $30.00 + 0 doi:10.067/mob.2003.396 Legal outcomes of sexual assault Jennifer Wiley, MD, a Naomi Sugar, MD, b David Fine, PhD, c and Linda O. Eckert, MD a Seattle, Wash OBJECTIVE: The study was undertaken to better describe the assault characteristics and examination find- ings in sexual assault victims who pursue legal action. STUDY DESIGN: A case-control study of consecutive women older than 15 years who came to an urban hospital after sexual assault over a 32-month period was conducted. All the women underwent a standard- ized history and physical examination by a resident in obstetrics and gynecology. Cases were those in which charges were filed against an assailant by the prosecutors’ office. The controls were the women assaulted immediately preceding and after each case. RESULTS: Of the 888 women undergoing evaluation in the emergency department, 132 (15%) had charges filed by the prosecutor. Characteristics positively associated with a legal outcome included being examined within 24 hours after assault, partner/spouse as an assailant, oral assault, and anogenital trauma (P < .05, .01, .05, .05, respectively). Amnesia at the time of assault and/or friend/acquaintance as assailant were neg- atively associated with a legal outcome (P < .01, .05, respectively). CONCLUSION: Although only 15% of sexual assault cases were resolved with a legal outcome, the data support the importance of a physical examination within 24 hours of the assault. Anogenital trauma is associ- ated with, but not a prerequisite for, a successful legal outcome. (Am J Obstet Gynecol 2003;188:1638-41.) Key words: Sexual assault, legal outcome, trauma