Domestic violence homicides: ED use before victimization

Area of Science:

• Forensic Medicine
• Public Health
• Emergency Medicine

Background:

• Domestic violence (DV) is a significant public health issue with fatal consequences.
• Understanding patterns of healthcare utilization among DV homicide victims is crucial for prevention.
• Previous emergency department (ED) visits by victims may offer opportunities for intervention.

Purpose of the Study:

• To document prior emergency department (ED) use among victims of domestic violence (DV) homicides.
• To identify the types of injuries presented by DV homicide victims in the ED.
• To assess the potential role of the ED in preventing DV-related fatalities.

Main Methods:

• Retrospective review of female domestic violence (DV) homicide cases investigated by the Kansas City, Missouri, Police Department (KCPD) over five years.
• Analysis of medical records from 12 hospitals to identify ED visits within two years preceding homicide.
• Classification of injuries using the Flitcraft Criteria.

Main Results:

• Of 139 female homicides, 34 (24.5%) were DV-related.
• Fifteen (44%) of DV homicide victims presented to an ED within two years of their death, with 48 total visits.
• Of these visits, 42% were injury-related, with head injuries, perineal lacerations, and sexual assaults being common. Evidence suggestive of battering was found in over half of the cases.

Conclusions:

• A significant proportion of domestic violence (DV) homicide victims utilize emergency department (ED) services prior to their death.
• EDs represent a critical point for identifying victims of domestic violence and initiating safety assessments.
• Universal screening in EDs could enhance the prevention of DV-related homicides.