TBI and Intimate Partner Violence in Women Presenting to Orthopedic Fracture Clinic

Victims of intimate partner violence (IPV) are at substantial risk for traumatic brain injury (TBI), as the head, neck and face are the areas most often targeted during episodes of abuse. Victims of IPV may present to health care practitioners, including orthopedic surgeons, with IPV-related injuries, but they are not routinely screened for TBI. There is increased awareness of IPV among orthopedic surgeons in Canada, and training is now available about how to address IPV in the fracture clinic. Prevalence of TBI in this group, however, is unknown. TBI-related cognitive disorders may increase risk for poor outcomes from IPV, thus knowledge about TBI prevalence in this group is critical for clinical intervention. This study aimed to determine prevalence of IPV and TBI among women presenting to orthopedic fracture clinic. We interviewed 105 women presenting at an orthopedic fracture clinic. All participants completed the Ohio State University TBI identification method-interview (OSU-TBI), the direct method of IPV screening questionnaire, a modified version of the HELPS questionnaire, and the neurobehavioral symptom inventory (NSI). Study variables were 12-month and lifetime prevalence of IPV, prevalence of mild and moderate-severe TBI, and prevalence of comorbid IPV and TBI. Forty-six of 105 women (43.8%) who completed the OSU-TBI reported at least one head or neck injury resulting in a TBI. Of women reporting TBI, 11 (23.9%) met criteria for moderate-severe TBI. Forty-four of 104 women who completed the IPV screening questionnaire women (42.3%) disclosed a history of IPV-related abuse within their lifetime, with 25 (24%) of these women reporting physical abuse. Twenty of these women (19.2%) reported a history of IPV-related abuse within the past twelve months, with 7 (6.7%) women reporting physical abuse. Of 104 women who completed both the OSU-TBI and the IPV screening, 23 (22.1%) had comorbid TBI (mild, moderate or severe) and lifetime history of IPV. These preliminary results suggest that a large proportion of women attending an orthopedic fracture clinic have experienced IPV (42.3%), TBI (43.8%), or comorbid IPV and TBI (22.1%). These findings point to a need for development of regular IPV and TBI screening tools among women presenting to health clinics for physical injuries, as well as the need for further investigation of the consequences of TBI among IPV victims.

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