Domestic violence and injuries - prevalence and patterns: A pilot database study to identify suspected cases in a UK major trauma centre

Hollie Garbett, Ben Carter, Alison Gregory, Helen Cramer, Natalia Lewis , Karen Morgan, Julian Thompson, Gene Feder, Philip Braude*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
Victim-survivors of domestic violence and abuse (DVA) are known to present to secondary care with isolated injuries to the head, limb or face. In the UK there are no published studies looking at the relationship of significant traumatic injuries in adults and the relationship to DVA, associated outcomes, or how it is managed within trauma pathways of care.
The primary objective was to assess the feasibility of using a tailored search method to identify cases of suspected DVA in the national audit database for trauma – TARN (Trauma Audit and Research Network). The secondary objective were to assess the association of DVA with clinical characteristics.

Methods
A single centre retrospective observational cross-sectional pilot study was undertaken. Data were analysed from the local TARN database. The ‘Scene Description’ field in the database was searched using a tailored search strategy formulated by a team of DVA and geriatric medicine researchers. Feasibility of this method was compared with review of medical notes and assessed by calculating the positive predictive value (PPV) and prevalence. The secondary (exploratory) objective was assessed with a logistic regression using a secure, anonymised Excel spreadsheet.
Results
This method of identifying suspected cases of DVA from the TARN database was feasible. All of identified cases of DVA were confirmed on examination of medical records.

The PPV was 100% and the prevalence of suspected DVA in the study period was 3.6 per 1000 trauma discharges. Of those who had experienced DVA, 52.7% were male, the median age was 43 (IQR: 33-52) and mortality was 5.5%. Subgroup analysis of patients 65 years old and over demonstrated increased length of hospital stay (p=0.17) and increased likelihood of admission to ITU (OR 2.60, 95% CI 0.48-14.24).

Conclusion
We have created a tailored, feasible methodology to identify suspected DVA related injuries within the TARN database. We have explored the local population characteristics in patients with suspected DVA to begin to understand the relationship to major trauma. Future work is needed to further understand this relationship on a national level.
Original languageEnglish
JournalInjury Prevention
Publication statusAccepted/In press - 18 Mar 2022

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