Urgent care-seeking and injury severity for intimate partner violence during COVID-19: a Canadian retrospective chart review

Alison N Ross; Emma Duchesne; Jane Lewis; Patrick A Norman; Susan A Bartels; Melanie Walker; Nicole Rocca

doi:10.1186/s12889-023-16991-z

Urgent care-seeking and injury severity for intimate partner violence during COVID-19: a Canadian retrospective chart review

BMC Public Health. 2023 Nov 6;23(1):2169. doi: 10.1186/s12889-023-16991-z.

Authors

Alison N Ross^{1

2}, Emma Duchesne³, Jane Lewis⁴, Patrick A Norman^{5

6}, Susan A Bartels^{7

3

6}, Melanie Walker^{7

3

6}, Nicole Rocca^{7

3}

Affiliations

¹ Faculty of Health Sciences (School of Medicine), Queen's University, Kingston, ON, Canada. aross@qmed.ca.
² Kingston Health Sciences Centre, 76 Stuart St, Victory 3, Kingston, ON, K7L 2V7, Canada. aross@qmed.ca.
³ Department of Emergency Medicine, Queen's University, Kingston, ON, Canada.
⁴ Sexual Assault & Domestic Violence Program, Kingston Health Sciences Centre, Kingston, ON, Canada.
⁵ Kingston General Health Research Institute, Kingston, ON, Canada.
⁶ Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
⁷ Faculty of Health Sciences (School of Medicine), Queen's University, Kingston, ON, Canada.

Abstract

Background: Early reports raised alarms that intimate partner violence (IPV) increased during the COVID-19 pandemic, but initial studies showed that visits to emergency departments (EDs) decreased. This study assessed the impact of the prolonged pandemic and its associated restrictions on both rates of urgent care-seeking and injury severity for IPV.

Methods: Data from the Kingston Health Sciences Centre's (KHSC) ED were utilized to compare IPV presentations during 'Pre-COVID' (December 17, 2018 - March 16, 2020) and 'COVID' (March 17, 2020 - June 16, 2021), as well as three periods of heightened local restrictions: 'Lockdown-1' (March 17 - June 12, 2020), 'Lockdown-2' (December 26, 2020 - February 10, 2021) and 'Lockdown-3' (April 8 - June 2, 2021). The primary outcomes were incidence rate of IPV visits and injury severity, which was assessed using the Clinical Injury Extent Score (CIES) and Injury Severity Score (ISS).

Results: A total of 128 individuals were included. This sample had mean age of 34 years, was comprised of mostly women (97%), and represented a variety of intimate relationship types. Some individuals presented multiple times, resulting in a total of 139 acute IPV presentations. The frequency of IPV visits during COVID was similar to the Pre-COVID time period (67 vs. 72; p = 0.67). Incidence rate was 13% higher during COVID, though this difference was non-significant (6.66 vs. 5.90; p = 0.47). IPV visit frequency varied across lockdown periods (11 in Lockdown-1, 12 in Lockdown-2 and 6 in Lockdown-3), with the highest incidence rate during Lockdown-2 (12.71). There were more moderate and severe injuries during COVID compared to Pre-COVID, but mean CIES was not statistically significantly different (1.91 vs. 1.69; p = 0.29), nor was mean ISS (11.88 vs. 12.52; p = 0.73).

Conclusions: During the 15-months following the start of COVID-19, there were small, but non-significant increases in both incidence rate and severity of IPV presentations to the KHSC ED. This may reflect escalation of violence as pandemic restrictions persisted and requires further investigation.

Keywords: COVID-19 pandemic; Domestic violence; Emergency department; Forensic medicine; Injuries; Intimate partner violence; Sexual assault; Trauma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Ambulatory Care
COVID-19*
Canada
Communicable Disease Control
Female
Humans
Intimate Partner Violence*
Male
Pandemics
Retrospective Studies