From the Departments of Radiology (E.G., C.H.P., N.S., B.K.) and Emergency Medicine (A.L., H.M.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass (B.R.).
Radiology. 2019 Apr;291(1):62-69. doi: 10.1148/radiol.2019180801. Epub 2019 Feb 5.
Purpose To assess the radiologic findings associated with intimate partner violence (IPV). Materials and Methods Electronic medical records of 185 patients referred to the IPV support program from the emergency department (ED) between January 2015 and October 2016 were retrospectively reviewed and compared with an age- and sex-matched control group of 555 subjects (1:3 ratio of IPV victims to control subjects) who presented to the ED. Reports of all imaging studies performed within 5 years prior to the index ED visit were reviewed. Results The majority of patients who experienced IPV (mean age, 34.2 years ± 12.2 [standard deviation]) were female (178 of 185 [96.2%]) and were largely African American (69 of 185 [37.3%]). Demographic and clinical variables independently associated with IPV were race (odds ratio [OR] range, 3.2-5.9; 95% confidence interval [CI]: 1.8, 12.7), psychiatric comorbidities (OR, 5.4; 95% CI: 3.4, 8.8), and homelessness (OR, 13.0; 95% CI: 5.4, 31.2). IPV victims underwent more imaging studies in the preceding 5 years (median, four studies) than did control subjects (median, one study). Obstetric-gynecologic findings (OR, 4.4; 95% CI: 2.1, 9.6) and acute fractures (OR, 2.4, 95% CI: 1.1, 5.3) seen on images were independently associated with IPV. The addition of imaging findings to demographic and clinical variables increased the area under the receiver operating characteristic curve (AUC) of the multivariate model to detect IPV (0.87 vs 0.86, P < .01), and the cross-validated multivariate model had an AUC of 0.85. Acute fractures involved the face or skull (range, P < .01 to P = .05), and chronic fractures affected the extremities and nasal bone (P < .01 and P = .05, respectively) more frequently in the IPV group than in the control group. Conclusion Intimate partner violence victims undergo more imaging studies and have a higher frequency of potential violence-related imaging findings when compared with age- and sex-matched control subjects. © RSNA, 2019 See also the editorial by Flores and Narayan in this issue.
目的 评估亲密伴侣暴力（IPV）相关的放射学表现。
材料与方法 回顾性分析 2015 年 1 月至 2016 年 10 月期间因 IPV 从急诊科（ED）转介到 IPV 支持项目的 185 例患者的电子病历，并与同期 ED 就诊的 555 例年龄和性别匹配的对照组（IPV 受害者与对照组的比例为 1:3）进行比较。回顾了所有在 ED 就诊前 5 年内进行的影像学检查报告。
结果 大多数经历过 IPV 的患者（平均年龄 34.2 岁±12.2[标准差]）为女性（185 例中的 178 例[96.2%]），且多为非裔美国人（185 例中的 69 例[37.3%]）。与 IPV 相关的独立人口统计学和临床变量为种族（比值比范围，3.2-5.9；95%置信区间：1.8，12.7）、合并精神疾病（比值比，5.4；95%置信区间：3.4，8.8）和无家可归（比值比，13.0；95%置信区间：5.4，31.2）。与对照组（中位数，1 项研究）相比，IPV 受害者在之前 5 年内接受了更多的影像学检查（中位数，4 项研究）。影像学上发现的产科-妇科表现（比值比，4.4；95%置信区间：2.1，9.6）和急性骨折（比值比，2.4，95%置信区间：1.1，5.3）与 IPV 独立相关。将影像学发现与人口统计学和临床变量结合起来，增加了多变量模型对 IPV 的检测的受试者工作特征曲线（AUC）（0.87 比 0.86，P<.01），且经过交叉验证的多变量模型 AUC 为 0.85。急性骨折累及面部或颅骨（范围，P<.01 至 P =.05），慢性骨折累及四肢和鼻骨（P<.01 和 P =.05）在 IPV 组比对照组更常见。
结论 与年龄和性别匹配的对照组相比，亲密伴侣暴力受害者接受的影像学检查更多，且更频繁地发现潜在与暴力相关的影像学表现。
