Domestic abuse in the emergency department

Can a risk profile be defined?

M. J. Zachary, M. N. Mulvihill, William B. Burton, L. R. Goldfrank

Research output: Contribution to journalArticle

27 Citations (Scopus)

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 cross-sectional 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.

Original languageEnglish (US)
Pages (from-to)796-803
Number of pages8
JournalAcademic Emergency Medicine
Volume8
Issue number8
StatePublished - 2001

Fingerprint

Hospital Emergency Service
Battered Women
Demography
Domestic Violence
Sex Offenses
Violence
Psychiatry
Cross-Sectional Studies
Wounds and Injuries

Keywords

  • Domestic violence
  • Partner abuse
  • Physician's role
  • Risk factors
  • Screening

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Zachary, M. J., Mulvihill, M. N., Burton, W. B., & Goldfrank, L. R. (2001). Domestic abuse in the emergency department: Can a risk profile be defined? Academic Emergency Medicine, 8(8), 796-803.

Domestic abuse in the emergency department : Can a risk profile be defined? / Zachary, M. J.; Mulvihill, M. N.; Burton, William B.; Goldfrank, L. R.

In: Academic Emergency Medicine, Vol. 8, No. 8, 2001, p. 796-803.

Research output: Contribution to journalArticle

Zachary, MJ, Mulvihill, MN, Burton, WB & Goldfrank, LR 2001, 'Domestic abuse in the emergency department: Can a risk profile be defined?', Academic Emergency Medicine, vol. 8, no. 8, pp. 796-803.
Zachary, M. J. ; Mulvihill, M. N. ; Burton, William B. ; Goldfrank, L. R. / Domestic abuse in the emergency department : Can a risk profile be defined?. In: Academic Emergency Medicine. 2001 ; Vol. 8, No. 8. pp. 796-803.
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