A 10-Year Retrospective Analysis of Intimate Partner Violence Patients in the Emergency Department

Abstract

BACKGROUND: Intimate partner violence (IPV) is an important human rights problem faced by one in three women worldwide. The aim of this study is to evaluate the demographic, trauma, and radiological characteristics of patients admitted to a tertiary emergency department due to IPV. METHODS: Sociodemographic characteristics (age, gender, education level, and marital status), trauma characteristics (severity, type, and location), radiological imaging findings (radiography, computed tomography, and magnetic resonance imaging) of patients diagnosed with IPV were evaluated. RESULTS:In the study, 1225 patients were evaluated, and 98.7% of them were women (mean age 35 [IQR: 17] years). Of the patients, 63.1% were high school and university graduates. The rate of married women was 74.6%. No relationship was found between gender, age, educational status, and marital status (p>0.05). Most of the traumas were minor (85.4%) and blunt (81.9%) trauma, and the most common types of trauma were kicking (49.9%) and punching (47.3%). It was found that the most frequently affected areas of the patients were the head and neck (76.7%), and the frequency of pelvic trauma was high in male patients (p<0.05). The most common bone fracture was nasal (40.5%) followed by ulna fractures (14.5%). The left-sided diaphyseal fractures were the most common in patients exposed to IPV. In our study, the frequency of mortality was 12.9%, and it was found to be significantly higher in males (p<0.05). CONCLUSION:Female patients are more frequently exposed to IPV. Specific injury characteristics can be detected in patients diagnosed with IPV and old fractures detected in these patients should alert the clinician about IPV.

Orthopaedic Injury Patterns in Intimate Partner Violence: Defensive Wounds and Fracture Patterns

“…Four studies focused on the general patterns of orthopaedic injury seen in survivors of IPV and characterized location of injury by upper or lower extremity. Our data support historical trends that upper extremity fractures are the second most common fracture in IPV victims 6,7,11,12 . Around one-third of the IPV cohort studied by Jospeh et al identified extremity fractures as a presenting injury.…”

“…Thomas et al supported this, finding 5 of 6 (83%) subacute or chronic fractures were in the hand 16 . Kavak et al reported 5.7% of patients with IPV history had chronic healing fractures characteristic of IPV 7 . The most common chronic fracture or evidence of a previous fracture was seen in the phalanges, followed by the radius and ulna.…”

“…Four studies noted phalanges fractures as the most common upper extremity fracture caused by IPV, whereas 2 other studies found ulnar fractures as most common 3,7,12,13,16,17 . Both studies that found ulnar fractures as the most common IPV associated fracture were longitudinal cohort reviews 7,11 . Jospeh et al used the National Trauma Database (NTDB) consisting of information from a range of rural and urban US EDs 11 .…”

“…Jospeh et al used the National Trauma Database (NTDB) consisting of information from a range of rural and urban US EDs 11 . Kavak et al studied fracture data from a tertiary hospital in Turkey 7 . The study cohort was limited to patients with initial radiologic imaging to evaluate a nonorthopaedic injury caused by IPV (e.g., abdominal computed tomography), followed by radiographs to evaluate a concomitant fracture.…”

“…These results were not limited to fractures and included other soft-tissue injuries such as contusions and sprains/ strains 16 . Kavak et al, limited their data to fractures and found that 63% of upper extremity fractures occurred on the left and 37% on the right 7 . Table II below demonstrates the different prevalences and locations of UEIs seen throughout included studies that emphasized UEIs as their primary study topic.…”