Universal screening for intimate partner and sexual violence in trauma patients: An EAST multicenter trial

Tanya Zakrison, Xiomara Ruiz, Rondi Gelbard, John Cline, David Turay, Xian Luo-Owen, Nicholas Namias, Marie Crandall, Jessica George, Brian H. Williams

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND A single-center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) among both male and female trauma patients, regardless of mechanism of injury. We aimed to determine if this phenomenon was similar to rates in other trauma centers by assessing the feasibility of universal screening and determining the prevalence and association of IPSV with other trauma-associated comorbidities. METHODS We designed an Eastern Association for the Surgery of Trauma-supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States. Screening occurred from March 2015 to April 2016. We performed universal screening of adult trauma patients using the validated HITS (Hurt, Insult, Threaten, Scream) and SAVE (sexual violence) screening surveys. Trauma recidivism, substance use, and mental illness were also measured and were classified as "trauma-associated comorbidities." Chi-squared test compared categorical variables with significance at p <0.05. Parametric data is presented as mean ± standard deviation. RESULTS A total of 2,034 eligible trauma patients were screened by clinical social workers at each site over 1 year. The mean age was 37.05 ± 20.32 with 63% men, 37% women, and one transgendered participant. The overall rate of IPSV was 11.4%. The proportion of positive screens for men was 9.3%, with variability between centers (3.8-72.7%), and for women was 16.1% (15.3-50.0%) (p < 0.001). The transgendered patient screened positive for IPSV. Of patients who screened positive for IPSV, 60.0% had one or more trauma-associated comorbidity compared to 15.1% of patients who screened negative (p < 0.001). CONCLUSION More than one in nine trauma patients is at risk of IPSV, regardless of gender or mechanism of injury. IPSV may be a risk factor for other trauma-associated comorbidities. LEVEL OF EVIDENCE Prognostic/Epidemiologic, level II; Care Management, level III.

Original languageEnglish (US)
Pages (from-to)105-110
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume83
Issue number1
DOIs
StatePublished - Jul 1 2017

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Sex Offenses
Multicenter Studies
Wounds and Injuries
Comorbidity
Transgender Persons
Trauma Centers
Intimate Partner Violence
Observational Studies
Cohort Studies

Keywords

  • Intimate partner violence
  • recidivism
  • sexual violence
  • trauma
  • universal

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Universal screening for intimate partner and sexual violence in trauma patients : An EAST multicenter trial. / Zakrison, Tanya; Ruiz, Xiomara; Gelbard, Rondi; Cline, John; Turay, David; Luo-Owen, Xian; Namias, Nicholas; Crandall, Marie; George, Jessica; Williams, Brian H.

In: Journal of Trauma and Acute Care Surgery, Vol. 83, No. 1, 01.07.2017, p. 105-110.

Research output: Contribution to journalArticle

Zakrison, Tanya ; Ruiz, Xiomara ; Gelbard, Rondi ; Cline, John ; Turay, David ; Luo-Owen, Xian ; Namias, Nicholas ; Crandall, Marie ; George, Jessica ; Williams, Brian H. / Universal screening for intimate partner and sexual violence in trauma patients : An EAST multicenter trial. In: Journal of Trauma and Acute Care Surgery. 2017 ; Vol. 83, No. 1. pp. 105-110.
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AU - Zakrison, Tanya

AU - Ruiz, Xiomara

AU - Gelbard, Rondi

AU - Cline, John

AU - Turay, David

AU - Luo-Owen, Xian

AU - Namias, Nicholas

AU - Crandall, Marie

AU - George, Jessica

AU - Williams, Brian H.

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N2 - BACKGROUND A single-center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) among both male and female trauma patients, regardless of mechanism of injury. We aimed to determine if this phenomenon was similar to rates in other trauma centers by assessing the feasibility of universal screening and determining the prevalence and association of IPSV with other trauma-associated comorbidities. METHODS We designed an Eastern Association for the Surgery of Trauma-supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States. Screening occurred from March 2015 to April 2016. We performed universal screening of adult trauma patients using the validated HITS (Hurt, Insult, Threaten, Scream) and SAVE (sexual violence) screening surveys. Trauma recidivism, substance use, and mental illness were also measured and were classified as "trauma-associated comorbidities." Chi-squared test compared categorical variables with significance at p <0.05. Parametric data is presented as mean ± standard deviation. RESULTS A total of 2,034 eligible trauma patients were screened by clinical social workers at each site over 1 year. The mean age was 37.05 ± 20.32 with 63% men, 37% women, and one transgendered participant. The overall rate of IPSV was 11.4%. The proportion of positive screens for men was 9.3%, with variability between centers (3.8-72.7%), and for women was 16.1% (15.3-50.0%) (p < 0.001). The transgendered patient screened positive for IPSV. Of patients who screened positive for IPSV, 60.0% had one or more trauma-associated comorbidity compared to 15.1% of patients who screened negative (p < 0.001). CONCLUSION More than one in nine trauma patients is at risk of IPSV, regardless of gender or mechanism of injury. IPSV may be a risk factor for other trauma-associated comorbidities. LEVEL OF EVIDENCE Prognostic/Epidemiologic, level II; Care Management, level III.

AB - BACKGROUND A single-center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) among both male and female trauma patients, regardless of mechanism of injury. We aimed to determine if this phenomenon was similar to rates in other trauma centers by assessing the feasibility of universal screening and determining the prevalence and association of IPSV with other trauma-associated comorbidities. METHODS We designed an Eastern Association for the Surgery of Trauma-supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States. Screening occurred from March 2015 to April 2016. We performed universal screening of adult trauma patients using the validated HITS (Hurt, Insult, Threaten, Scream) and SAVE (sexual violence) screening surveys. Trauma recidivism, substance use, and mental illness were also measured and were classified as "trauma-associated comorbidities." Chi-squared test compared categorical variables with significance at p <0.05. Parametric data is presented as mean ± standard deviation. RESULTS A total of 2,034 eligible trauma patients were screened by clinical social workers at each site over 1 year. The mean age was 37.05 ± 20.32 with 63% men, 37% women, and one transgendered participant. The overall rate of IPSV was 11.4%. The proportion of positive screens for men was 9.3%, with variability between centers (3.8-72.7%), and for women was 16.1% (15.3-50.0%) (p < 0.001). The transgendered patient screened positive for IPSV. Of patients who screened positive for IPSV, 60.0% had one or more trauma-associated comorbidity compared to 15.1% of patients who screened negative (p < 0.001). CONCLUSION More than one in nine trauma patients is at risk of IPSV, regardless of gender or mechanism of injury. IPSV may be a risk factor for other trauma-associated comorbidities. LEVEL OF EVIDENCE Prognostic/Epidemiologic, level II; Care Management, level III.

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