Universal Screening for Intimate Partner and Sexual Violence in Trauma Patients: An EAST Multicenter Trial

BACKGROUND: A single center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) amongst 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 EAST- supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States. Screening occurred from 03/15-04/16. 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 2034 eligible trauma patients were screened by clinical social workers at each site over one 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 that screened positive for IPSV, 60.0% had one or more trauma-associated comorbidity compared to 15.1% of patients that screened negative (p<0.001). CONCLUSION: More than 1 in 9 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:: III STUDY TYPE:: Diagnostic