Affiliation:
1. Trauma Imaging Research and Innovation Center, Department of Radiology and Medicine Brigham and Women's Hospital Boston Massachusetts USA
2. Larner College of Medicine University of Vermont Burlington Vermont USA
3. Department of Obstetrics and Gynecology Brigham and Women's Hospital Boston Massachusetts USA
4. Department of Orthopedic Surgery, Indiana University School of Medicine Riley Children's Hospital Indianapolis Indiana USA
Abstract
AbstractBackgroundFalls and interpersonal violence pose significant threats to older adults, leading to injuries, hospitalizations, and emergency department (ED) visits. This study investigates the demographics and injury patterns in older adults (aged 60 and above) who sought ED care due to assaults, comparing them with those who experienced falls to gain a deeper understanding of older adult abuse patterns.MethodThis study utilizes data from the National Electronic Injury Surveillance System (NEISS) All Injury Program (2005–2019) to examine injuries among older adults aged 60 years and above. Participants were categorized into two groups: older adult abuse and injuries due to falls. The differences between the groups by demographics, injury locations, patterns, and temporal trends were analyzed using statistical methods accounting for the weighted stratified nature of the data. Cosinor analysis and Joinpoint regression were used for temporal analysis.ResultsOver 15 years, there were an estimated 307,237 ED visits for older adult abuse and 39,477,217 for falls. Older adults experiencing abuse were younger and had lower hospital admission rates compared to fall patients. Injuries associated with abuse included contusions/abrasions, penetrating injuries, and fractures to the head/neck, fingers, toes, ribs, and lower extremities. In contrast, fall patients had higher admission rates, with more fractures, including cervical spine and hip fractures. Temporal patterns showed a higher rate of assaults during the summer, whereas abuse demonstrated bimodal peaks in the summer and fall.ConclusionsInjuries associated with abuse such as facial, upper trunk, and upper extremity fractures should raise suspicion even in the absence of severe symptoms. These findings emphasize the importance of early identification to connect older adults with support resources, as patients experiencing abuse often get discharged from the ED.
Funder
National Institute of Biomedical Imaging and Bioengineering
National Institutes of Health