How Often Do Women in the Emergency Department without Intimate Violence Injuries Return with Such Injuries?

Muelleman, Robert L.; Liewer, Joseph D.

doi:10.1111/j.1553-2712.1998.tb02775.x

Cited by 17 publications

(11 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only 42% of the clinical presentations of these homicide victims were due to trauma. 24 Other evidence supports these findings, indicating that limited screening efforts are flawed. [25][26][27][28] Risk factors for recent domestic abuse found in this study were trauma, obstetrical and gynecological syndromes, and psychiatric symptoms and substance use.…”

Section: Discussionsupporting

confidence: 60%

“…Other studies have shown that women killed by an abusive partner commonly present to the ED prior to death and that the majority of women who have been raped and physically assaulted seek care in the emergency department. [22][23][24] Second, demographic and clinical presentations of women are poor predictors of who has been abused. Therefore, asking only those women with assault-related injuries or with ''high-risk'' non-injury presentations about abuse is misleading and will underrepresent the problem.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Domestic Abuse in the Emergency Department: Can a Risk Profile Be Defined?

Zachary

Mulvihill

Burton

et al. 2001

Academic Emergency Medicine

View full text Add to dashboard Cite

Abstract. Objectives:The main purpose of this study was to determine whether any clinical or demographic characteristics could identify adult female patients presenting to the emergency department (ED) with a history of domestic abuse. A second objective was to describe the frequency, types, and severity of this abuse. Methods: This study was a crosssectional survey of 611 women conducted in an academically-affiliated, urban ED. Domestic abuse was described as ''recent'' (within the preceding 12 months) or ''lifetime'' (recent or past). This included emotional, physical, and sexual abuse. Results: Recent (7.9%, n = 48) and lifetime (38%, n = 232) domestic abuse was reported. For recently abused women, violence had been severe (87.5%, n = 42) and was associated with 1) trauma (OR 5.4, 95% CI = 2.6 to 11.6), 2) obstetrical and gynecological syndromes (OR 5.6, 95% CI = 2.4 to 13.2), and 3) psychiatric symptoms and substance use (OR 7.3, 95% CI = 2.4 to 22.0). The sensitivities and positive predictive values of these risk factors individually (<27.1% and <25.0%, respectively) and in aggregate (56.3% and 20.9%, respectively) were low. These indicators predicted only 27 (56.3%) of recently abused women. Lifetime domestic violence was more likely in homeless women (OR 5.8, 95% CI = 2.2 to 15.0), although less likely in immigrants (OR 0.4, 95% CI = 0.3 to 0.7). Conclusions: Clinical presentations and demographic characteristics of women presenting to the ED may not be sensitive or predictive indicators of domestic abuse. In the absence of typical clinical or demographic findings, asking all women in the ED about domestic abuse remains a necessary priority. Key words: domestic violence; screening; physician's role; risk factors; partner abuse. ACADEMIC EMER- GENCY MEDICINE 2001; 8:796-803 I N 1992, the American Medical Association published guidelines recommending that medical providers routinely ask all women direct, specific questions about abuse.1 Subsequently, many national medical associations have developed similar guidelines.2-6 Despite these intentions, these recommendations have been fraught with difficulty and remain largely unrealized. Most physicians in the emergency department (ED), as in most settings, do not routinely ask their patients about domestic abuse.7,8 A recent study showed that fewer than 10% of primary care physicians in California routinely take a history about abuse. 9 In the ED, clinicians may be more likely to ask about abuse in women who present with assault-related inju- 10,11 However, women with acute presentations of domestic abuse often do not present with injuries. 12-14The complexity of routinely inquiring about domestic abuse in medical settings has been described. 10,15 Asking all women about this problem may be unrealistic, screening standards are not uniform, and few studies have evaluated the effectiveness of these efforts. However, several programs have achieved the goal of universal screening. 16 In addition, experts assert, and a small body of evidence suggests, that wome...

show abstract

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Domestic Abuse in the Emergency Department: Can a Risk Profile Be Defined?

Zachary

Mulvihill

Burton

et al. 2001

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…In the 57 months prior to that visit, these patients were two times more likely to have had an ED visit for a diagnosis other than intimate partner violence than a control group. 20 We found that this sort of approach leads to a more global view of the repeat visits. In our study, we found that "different-category" repeaters accounted for 58% of transported subjects, a group that would have been missed if we had looked only at a specific diagnostic category.…”

Section: Discussionmentioning

confidence: 80%

R Epeat Ems T Ransports Among E Lderly E Mergency D Epartment P Atients

Weiss

Ernst

Miller

et al. 2002

Prehospital Emergency Care

View full text Add to dashboard Cite

Repeaters accounted for 18% of elderly ED patients transported by EMS and 40% of elderly transports to the authors' ED. There were significantly fewer trauma transports in the repeater group. One-half of the repeaters returned only once in a 12-month period and a third of these occurred more than three months apart. It is important to understand the characteristics of elderly EMS repeaters in order to use this opportunity for intervention.

show abstract

“…[7][8][9] In the emergency department (ED) setting, however, 1% to 6% of women are diagnosed with IPV-related injuries. 4,7 Although future episodes of violence may be prevented by appropriate and timely intervention, interventional activities, systems, or processes cannot be initiated until a diagnosis of IPV is entertained. Early and accurate diagnosis, prompting intervention, continues to be problematic.…”

mentioning

confidence: 99%

“…IPV is characterized as a chronic, recurrent disease with increasing frequency and severity of the assaults. [1][2][3][4] In the United States, 1,000,000 to 2,000,000 women are injured yearly due to IPV-related assaults. [5][6][7][8] IPV is underdiagnosed and underreported.…”

mentioning

confidence: 99%