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 c onfirm and refine the role of head, neck, and face (HNF) injuries as marker s 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 Me morial Hospital, Atlanta, GA) were used. The predictor study variable was i njury 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 gav e a history of being injured by her spouse or sexual partner. Other data in cluded age, nature of the injury (blunt or penetrating), and injury severit y 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 wi th a mean age of 43.9 +/- 18.2 year in the other-causes group (P = .001). T he mean ISS for the DV victims was 3.4 +/- 3.0, and the mean ISS for the ot her-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 contr olling 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 sensi tive predictors of DV, they remain poor in their specificity as markers.