Is There an Association Between History of Intimate Partner Violence and Reported Health Outcomes After Orthopaedic...

Area of Science:

• Orthopedic Surgery
• Public Health
• Trauma Care

Background:

• Intimate partner violence (IPV) affects a significant portion of the population, with musculoskeletal injuries being a common manifestation.
• Existing research on IPV is limited, particularly concerning diverse populations, men, and long-term patient-reported outcomes.
• There is a need to understand the impact of IPV on health-related quality of life in patients presenting with injuries.

Purpose of the Study:

• To determine if patients screening positive for IPV after an injury report lower health-related quality of life compared to those screening negative.
• To investigate the utility of IPV screening tools in an orthopedic hand and upper extremity clinic setting.
• To assess the impact of IPV on specific domains of health-related quality of life.

Main Methods:

• A prospective study involving 500 patients with acute upper extremity injuries at an urban trauma hospital.
• Patients were screened for IPV using the Direct IPV and Extended Hurt, Insult, Threaten, Scream (E-HITS) tools.
• Health-related quality of life was assessed using the EQ-5D-3L survey, with data analyzed using Kruskal-Wallis tests, chi-square/Fisher exact tests, and logistic regression.

Main Results:

• Twenty-four percent (120 of 500) of patients screened positive for lifetime IPV.
• Patients screening positive for IPV reported significantly lower health-related quality of life (EQ-5D-3L scores) compared to those who screened negative (median 8.0 vs. 7.0, p=0.003).
• The difference in EQ-5D-3L scores surpassed the minimum clinically important difference (MCID) in mobility, pain/discomfort, and anxiety/depression subcategories for the IPV-positive group.

Conclusions:

• This study, conducted in a diverse, underserved population, demonstrates the effectiveness of standardized IPV screening tools.
• Patients disclosing IPV reported greater disability, with quality of life scores significantly impacted across multiple domains.
• Orthopaedic surgeons should consider prospective IPV screening for patients with upper extremity injuries to facilitate referrals and improve health outcomes.