Head, neck, and facial injuries as markers of domestic violence in women

Purpose: The diagnosis of domestic violence (DV) is difficult because of a lack of clearly defined signs and symptoms. The goal of this study was to confirm and refine the role of head, neck, and face (HNF) injuries as markers of DV. Patients and Methods: A cross-sectional study design and a sample of female trauma patients treated in an inner-city hospital emergency room (Grady Memorial Hospital, Atlanta, GA) were used. The predictor study variable was injury location (HNF or other location). The outcome variable was traumatic origin (DV or other cause). A victim of DV was defined as a patient who gave a history of being injured by her spouse or sexual partner. Other data included age, nature of the injury (blunt or penetrating), and injury severity score (ISS). Descriptive, bivariate, and logistic regression statistical analyses were performed. Results: The sample consisted of 100 injured women, with a mean age of 40 +/- 16.3 years and a mean ISS of 3.3 +/- 3.0. Thirty-four women were victims of DV. The mean age of the DV victims mras 32.5 +/- 7.3 years, compared with a mean age of 43.9 +/- 18.2 year in the other-causes group (P = .001). The mean ISS for the DV victims was 3.4 +/- 3.0, and the mean ISS for the other-causes group was 3.2 +/- 3.0 (P = .65). DV victims were 7.5 (2.5 < RR < 22.9) times more likely to have HNF injuries than other trauma patients (P < .001). Age was associated with cause and location of injury. After controlling for age, location remained statistically associated with cause (P = .0002). Sensitivity and specificity of HNF injuries and DV were 91% and 59%, respectively. Conclusions: The data suggest that although HNF injuries and age were sensitive predictors of DV, they remain poor in their specificity as markers.