Radiologic Findings in Intimate Partner Violence

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Published Online:Feb 5 2019https://doi.org/10.1148/radiol.2019180801

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Abstract

Victims of intimate partner violence undergo more imaging studies and have a higher frequency of potential violence-related imaging findings, such as acute fractures and obstetric-gynecologic findings, when compared with age- and sex-matched control subjects.

Purpose

To assess the radiologic findings associated with intimate partner violence (IPV).

Materials and Methods

Electronic medical records of 185 patients referred to the IPV support program from the emergency department (ED) between January 2015 and October 2016 were retrospectively reviewed and compared with an age- and sex-matched control group of 555 subjects (1:3 ratio of IPV victims to control subjects) who presented to the ED. Reports of all imaging studies performed within 5 years prior to the index ED visit were reviewed.

Results

The majority of patients who experienced IPV (mean age, 34.2 years ± 12.2 [standard deviation]) were female (178 of 185 [96.2%]) and were largely African American (69 of 185 [37.3%]). Demographic and clinical variables independently associated with IPV were race (odds ratio [OR] range, 3.2–5.9; 95% confidence interval [CI]: 1.8, 12.7), psychiatric comorbidities (OR, 5.4; 95% CI: 3.4, 8.8), and homelessness (OR, 13.0; 95% CI: 5.4, 31.2). IPV victims underwent more imaging studies in the preceding 5 years (median, four studies) than did control subjects (median, one study). Obstetric-gynecologic findings (OR, 4.4; 95% CI: 2.1, 9.6) and acute fractures (OR, 2.4, 95% CI: 1.1, 5.3) seen on images were independently associated with IPV. The addition of imaging findings to demographic and clinical variables increased the area under the receiver operating characteristic curve (AUC) of the multivariate model to detect IPV (0.87 vs 0.86, P < .01), and the cross-validated multivariate model had an AUC of 0.85. Acute fractures involved the face or skull (range, P < .01 to P = .05), and chronic fractures affected the extremities and nasal bone (P < .01 and P = .05, respectively) more frequently in the IPV group than in the control group.

Conclusion

Intimate partner violence victims undergo more imaging studies and have a higher frequency of potential violence-related imaging findings when compared with age- and sex-matched control subjects.

See also the editorial by Flores and Narayan in this issue.

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Article History

Received: Apr 6 2018
Revision requested: May 4 2018
Revision received: Nov 29 2018
Accepted: Dec 12 2018
Published online: Feb 05 2019
Published in print: Apr 2019

Vol. 291, No. 1

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Abbreviations

Abbreviations:
AUC	area under the receiver operating characteristic curve
ED	emergency department
IPV	intimate partner violence

Metrics

Altmetric Score

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