Assault related injury visits in US emergency departments: An analysis by weekday, month and weekday-by-month

Injury patterns and demographics in older adult abuse and falls: A comparative study in emergency department settings

BACKGROUND

Falls and interpersonal violence pose significant threats to older adults, leading to injuries, hospitalizations, and emergency department (ED) visits. This study investigates the demographics and injury patterns in older adults (aged 60 and above) who sought ED care due to assaults, comparing them with those who experienced falls to gain a deeper understanding of older adult abuse patterns.

METHOD

This study utilizes data from the National Electronic Injury Surveillance System (NEISS) All Injury Program (2005-2019) to examine injuries among older adults aged 60 years and above. Participants were categorized into two groups: older adult abuse and injuries due to falls. The differences between the groups by demographics, injury locations, patterns, and temporal trends were analyzed using statistical methods accounting for the weighted stratified nature of the data. Cosinor analysis and Joinpoint regression were used for temporal analysis.

RESULTS

Over 15 years, there were an estimated 307,237 ED visits for older adult abuse and 39,477,217 for falls. Older adults experiencing abuse were younger and had lower hospital admission rates compared to fall patients. Injuries associated with abuse included contusions/abrasions, penetrating injuries, and fractures to the head/neck, fingers, toes, ribs, and lower extremities. In contrast, fall patients had higher admission rates, with more fractures, including cervical spine and hip fractures. Temporal patterns showed a higher rate of assaults during the summer, whereas abuse demonstrated bimodal peaks in the summer and fall.

CONCLUSIONS

Injuries associated with abuse such as facial, upper trunk, and upper extremity fractures should raise suspicion even in the absence of severe symptoms. These findings emphasize the importance of early identification to connect older adults with support resources, as patients experiencing abuse often get discharged from the ED.

Imaging of Intimate Partner Violence, From the AJR Special Series on Emergency Radiology

Intimate partner violence (IPV) is a highly prevalent public health issue with multiple adverse health effects. Radiologists are well suited to assessing a patient's likelihood of IPV. Recognition of common IPV injury mechanisms and resulting target and defensive injury patterns on imaging and understanding of differences between patients who have experienced IPV and those who have not with respect to use of imaging will aid radiologists in accurate IPV diagnosis. Target injuries often involve the face and neck as a result of blunt trauma or strangulation; defensive injuries often involve an extremity. Awareness of differences in injury patterns resulting from IPV-related and accidental trauma can aid radiologists in detecting a mismatch between the provided clinical history and imaging findings to support suspicion of IPV. Radiologists should consider all available current and prior imaging in assessing the likelihood of IPV; this process may be aided by machine learning methods. Even if correctly suspecting IPV on the basis of imaging, radiologists face challenges in acting on that suspicion, including appropriately documenting the findings, without compromising the patient's confidentiality and safety. However, through a multidisciplinary approach with appropriate support mechanisms, radiologists may serve as effective frontline physicians for raising suspicion of IPV.

Holiday effect on injuries sustained by assault victims seen in US emergency departments

PURPOSE

There has been a limited and inconsistent analysis of assault-related injury patterns associated with holidays. We investigated the temporal variation in assault-related injuries presenting to US emergency departments (ED) around holidays.

METHODS

We examined data from the National Electronic Injury Surveillance System Database between 2005 and 2017 for six categories of assault-related injuries: altercation, sexual assault, robbery, intimate partner violence (IPV), other specified, and unknown. Differences between holiday and non-holiday periods were analyzed for each assault type.

RESULTS

There was a significant difference in overall assault-related injury visits between holiday and non-holiday periods (p < 0.00001). Of over 21 million assault-related injury visits, 14.9% occurred during holiday periods and 85% during non-holiday periods. The difference between the daily number of assault-related ED visits was also significantly higher during the holiday period than baseline non-holiday period (p < 0.00001). Altercations and IPV were significantly higher than baseline for New Year's Eve (highest), St. Patrick's Day, July 4th, and Labor Day. IPV also remained significantly higher than baseline during Thanksgiving and Christmas. Sexual assaults were significantly higher than baseline during the New Year's Eve period but lower than baseline during Christmas and Easter.

CONCLUSIONS

Holidays are associated with increase in several assault-related injuries. The information can help allocate healthcare resources and guide prevention strategies.