Albert Einstein College of Medicine, Department of Emergency Medicine, Bronx, New York.
Jacobi Medical Center and North Central Bronx Hospital, Department of Emergency Medicine, Bronx, New York.
West J Emerg Med. 2022 Aug 19;23(5):672-677. doi: 10.5811/westjem.2022.1.53994.
The emergency department (ED) is at the forefront for treatment of sexual assault patients. Many require treatment for injuries sustained during the assault, ranging from mild to severe. Our objective in this study was to characterize types of injuries associated with sexual assault and identify associated factors.
We reviewed ED charts from an inner-city trauma center and nearby community hospital from 2019-2020 for patients age ≥13 years with a chief complaint of sexual assault. We used descriptive statistics, chi square, and logistic regression to characterize demographics and identify factors associated with trauma.
A total of 157 patients met inclusion criteria. The mean age was 27.9 years old (range 13-79 years) and 92.4% were female. Adult patients (age >18 years) comprised 77.5% of assaults vs adolescents (age 13-18 years) at 22.3%. Most patients presented to the trauma center compared to the community hospital (69.4% vs 30.6%). The assailants were reported as 61.2% acquaintance, 22.9% stranger, and 15.9% intimate partner. A forensic rape kit was performed in 92 (58.6%) cases. The patient was intoxicated with alcohol in 39 (24.8%) cases, and 22 (14%) patients reported drug-facilitated assault where an unknown substance was given to them. Alcohol (P = 0.95) and drug-facilitated assault (P = 0.64) did not change the occurrence of injuries. Fifty-seven (36.3%) patients exhibited physical trauma on presentation. Forty-five (28.6%) patients had minor injuries of abrasions, lacerations, or contusions. Major trauma was defined as fracture, brain injury, hemorrhage, strangulation, or injury requiring surgical consultation. There were 12 patients with major trauma consisting of fracture injury or nonfatal strangulation. None of the patients required admission. Sexual assault by an intimate partner (odds ratio [OR] 2.6; 95% CI: 1.1-6.5) and being an adult patient compared to adolescent (OR 3.0; 95% CI, 1.1-7.7) was significantly associated with physical trauma. Sexual assault by an intimate partner was also associated with nonfatal strangulation (OR 4.0; 95% CI, 1.1-15.4).
Physical injuries that resulted from sexual assault were mostly minor and occurred in 36% of rape victims. Intimate partner violence was found to be associated with physical trauma as well as nonfatal strangulation. Overall, this study helps us to understand key factors associated with sexual violence.
急诊科（ED）是治疗性侵犯患者的第一线。许多患者需要治疗在袭击中受伤，从轻度到重度不等。我们在这项研究中的目的是描述与性侵犯相关的伤害类型，并确定相关因素。
我们回顾了 2019-2020 年来自市区创伤中心和附近社区医院的年龄≥13 岁、以性侵犯为主要主诉的 ED 图表。我们使用描述性统计、卡方检验和逻辑回归来描述人口统计学特征，并确定与创伤相关的因素。
共有 157 名符合纳入标准的患者。平均年龄为 27.9 岁（范围 13-79 岁），92.4%为女性。成年患者（年龄>18 岁）占 77.5%，青少年（年龄 13-18 岁）占 22.3%。与社区医院相比，大多数患者被送往创伤中心（69.4%比 30.6%）。袭击者被报告为 61.2%是熟人，22.9%是陌生人，15.9%是亲密伴侣。在 92 例（58.6%）病例中进行了法医强奸套件检查。39 例（24.8%）患者在酒精中毒状态下，22 例（14%）患者报告药物辅助性侵犯，他们被给予了未知物质。酒精（P=0.95）和药物辅助性侵犯（P=0.64）并未改变伤害的发生。57 名（36.3%）患者在就诊时表现出身体创伤。45 名（28.6%）患者有轻微的擦伤、撕裂伤或挫伤。主要创伤定义为骨折、脑损伤、出血、绞杀或需要手术咨询的创伤。有 12 名患者有主要创伤，包括骨折损伤或非致命性绞杀。没有患者需要住院治疗。与亲密伴侣发生性侵犯（优势比[OR]2.6；95%置信区间：1.1-6.5）和成年患者相比青少年（OR 3.0；95%置信区间，1.1-7.7）与身体创伤显著相关。与亲密伴侣发生性侵犯也与非致命性绞杀相关（OR 4.0；95%置信区间，1.1-15.4）。
性侵犯导致的身体伤害大多是轻微的，在 36%的强奸受害者中发生。亲密伴侣暴力与身体创伤以及非致命性绞杀有关。总体而言，这项研究有助于我们了解与性暴力相关的关键因素。
