Tony Rosen1, Veronica M LoFaso2, Elizabeth M Bloemen3, Sunday Clark4, Thomas J McCarthy5, Christopher Reisig4, Kriti Gogia4, Alyssa Elman4, Arlene Markarian6, Neal E Flomenbaum4, Rahul Sharma4, Mark S Lachs2. 1. Department of Emergency Medicine, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY. Electronic address: aer2006@med.cornell.edu. 2. Division of Geriatrics and Palliative Care, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY. 3. University of Colorado School of Medicine, Aurora, CO. 4. Department of Emergency Medicine, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY. 5. Tulane University School of Medicine, New Orleans, LA. 6. Elder Abuse Unit, King's County District Attorney's Office, Brooklyn, NY.
Abstract
STUDY OBJECTIVE: Elder abuse is common and has serious health consequences but is underrecognized by health care providers. An important reason for this is difficulty in distinguishing between elder abuse and unintentional trauma. Our goal was to identify injury patterns associated with physical elder abuse in comparison with those of patients presenting to the emergency department (ED) with unintentional falls. METHODS: We partnered with a large, urban district attorney's office and examined medical, police, and legal records from successfully prosecuted cases of physical abuse of victims aged 60 years or older from 2001 to 2014. RESULTS: We prospectively enrolled patients who presented to a large, urban, academic ED after an unintentional fall. We matched 78 cases of elder abuse with visible injuries to 78 unintentional falls. Physical abuse victims were significantly more likely than unintentional fallers to have bruising (78% versus 54%) and injuries on the maxillofacial, dental, and neck area (67% versus 28%). Abuse victims were less likely to have fractures (8% versus 22%) or lower extremity injuries (9% versus 41%). Abuse victims were more likely to have maxillofacial, dental, or neck injuries combined with no upper and lower extremity injuries (50% versus 8%). Examining precise injury locations yielded additional differences, with physical elder abuse victims more likely to have injuries to the left cheek or zygoma (22% versus 3%) or on the neck (15% versus 0%) or ear (6% versus 0%). CONCLUSION: Specific, clinically identifiable differences may exist between unintentional injuries and those from physical elder abuse. This includes specific injury patterns that infrequently occur unintentionally.
STUDY OBJECTIVE: Elder abuse is common and has serious health consequences but is underrecognized by health care providers. An important reason for this is difficulty in distinguishing between elder abuse and unintentional trauma. Our goal was to identify injury patterns associated with physical elder abuse in comparison with those of patients presenting to the emergency department (ED) with unintentional falls. METHODS: We partnered with a large, urban district attorney's office and examined medical, police, and legal records from successfully prosecuted cases of physical abuse of victims aged 60 years or older from 2001 to 2014. RESULTS: We prospectively enrolled patients who presented to a large, urban, academic ED after an unintentional fall. We matched 78 cases of elder abuse with visible injuries to 78 unintentional falls. Physical abuse victims were significantly more likely than unintentional fallers to have bruising (78% versus 54%) and injuries on the maxillofacial, dental, and neck area (67% versus 28%). Abuse victims were less likely to have fractures (8% versus 22%) or lower extremity injuries (9% versus 41%). Abuse victims were more likely to have maxillofacial, dental, or neck injuries combined with no upper and lower extremity injuries (50% versus 8%). Examining precise injury locations yielded additional differences, with physical elder abuse victims more likely to have injuries to the left cheek or zygoma (22% versus 3%) or on the neck (15% versus 0%) or ear (6% versus 0%). CONCLUSION: Specific, clinically identifiable differences may exist between unintentional injuries and those from physical elder abuse. This includes specific injury patterns that infrequently occur unintentionally.
Authors: Ko Ling Chan; Wai Man Anna Choi; Daniel Y T Fong; Chun Bong Chow; Ming Leung; Patrick Ip Journal: J Emerg Med Date: 2012-07-16 Impact factor: 1.484
Authors: Tarshona B Stevens; Natalie L Richmond; Gregory F Pereira; Christina L Shenvi; Timothy F Platts-Mills Journal: Acad Emerg Med Date: 2014-06 Impact factor: 3.451
Authors: Sonya Daria; Naomi F Sugar; Kenneth W Feldman; Stephen C Boos; Scott A Benton; Amy Ornstein Journal: Pediatr Emerg Care Date: 2004-05 Impact factor: 1.454
Authors: Miriam E van Houten; Lilian C M Vloet; Thomas Pelgrim; Udo J L Reijnders; Sivera A A Berben Journal: Eur Geriatr Med Date: 2021-09-13 Impact factor: 1.710