Quarantine Leads to Increased Domestic Violence Traumas
Radiologists should continue to be aware of emergency department trauma cases that could be domestic violence
At the outset of the COVID-19 quarantine, emergency departments (ED) saw a significant decrease in overall radiology trauma case volume. Yet a disturbing new trend in increased domestic violence traumas began to emerge, revealing an opportunity for better resource planning and preparation for future pandemics.
This shift in the type of trauma cases was an unexpected finding at the center of a retrospective study conducted by Benjamin Jang, MD, third-year resident in radiology and biomedical imaging at the Yale School of Medicine (YSM).
“We hoped to break down new cases during quarantine to better understand new trends in ER cases in the setting of a quarantine and prepare for future pandemics,” he said. “We did not expect to find significantly higher rates of domestic violence during that period.”
Using clinical analytics software, Dr. Jang reviewed the records of patients coming to the emergency room for trauma-related causes requiring imaging. He looked at records from the first two weeks of the quarantine period, from March 23 to April 5, 2020, and compared them to records from a similar pre-quarantine date range, from March 25 to April 7, 2019. The records were selected using terms like fracture, laceration, fall and other trauma-related terminology.
“This process also pulled some irrelevant reports that required exclusion,” he said, “but most of the exclusions occurred because they did not meet the criteria that the trauma had to occur on the day of the emergency department arrival.”
In all, 783 patients from the pre-quarantine pool and 208 patients from the quarantine pool met the study criteria.
“We hoped to break down new cases during quarantine to better understand new trends in ER cases in the setting of a quarantine and prepare for future pandemics. We did not expect to find significantly higher rates of domestic violence during that period."
Benjamin Jang, MD
Accidental Injuries Decrease, Domestic Violence Climbs
The results revealed a 73.4% decrease in the number of trauma-related imaging studies from the pre-quarantine period to the quarantine period.
“We saw significant decreases in vehicular accidents and outside falls likely attributed to people driving less and following quarantine restrictions,” Dr. Jang said.
Social distancing and a halt to group activities contributed to the reduction of sports and other outdoor injuries. “Stresses related to prolonged indoor enclosure in a reduced space, and an inability to avoid the abusive individual, were likely reasons for increases in domestic violence traumas,” said Dr. Jang, who reported a significant increase in domestic violence and falls at home during the quarantine period.
He noted that the findings were echoed in the media with similar reports occurring globally and other experts attributing some of the problem to economic hardship caused by business closures. In addition, with schools and daycare centers closed, abuses were no longer being detected and reported by educators.
The data from this study provides an opportunity for emergency department staffing and resource adjustments. Dr. Jang said that the initial decrease in ER volume, and consequent decrease in emergency radiology case volume, resulted in decreased staffing, however those numbers have largely returned to normal for emergency radiology staffing at YSM.
While acknowledging he is not an expert on the issue, Dr. Jang said additional awareness by police and the public as well as increased access to resources like shelters, counseling and legal services might help those at increased risk of domestic violence during a quarantine.
For More Information
View the RSNA 2020 presentation, “Emergency Radiology Trauma Cases During COVID-19 Quarantine,” at RSNA2020.RSNA.org.
View previous RSNA News stories on intimate partner violence:
- Clinicians Can Identify and Intervene in Cases of Abuse by Intimate Partners if they Know How to Spot Them
- Radiology Plays Vital Role in Detecting Intimate Partner Violence