Keywords:
Forensic / Necropsy studies, Emergency, CT, Image manipulation / Reconstruction, Conventional radiography, Diagnostic procedure, Medico-legal issues, Observer performance, Trauma, Forensics, Acute
Authors:
M. Matteoli, C. De Dominicis, D. Serata, V. David; Rome/IT
DOI:
10.1594/ecr2013/C-0280
Results
Demographic data and gravity code were summarized in the Table I.
The main difference between the groups for what concerns descriptive data (Tab.
II) is the time to presentation in ED.
It’s clear that the majority of women (51%) referred the emergency room with a longer delay than 24 hours,
while in the other two groups about 91% of the patients referred to emergency room within 24 h ( p<0,0001).
Subgroup analysis (Tab IV) shows that pregnant women (Tab IV) (16pz) go first in the emergency department (73% within 24 h) and report first them partner (p= 0.07).
In the patients of our study,
the most common target of violence was the trunk (p=0,0003); there were no statistical significance in the other parameters.
It noteworthy that the 27% of the patients in the IPV group showed “dissociation between histories” differing from the control groups (p<0,0001).
Table III shows that the lesions among women subjected to domestic violence are more directed to the face,
instead subjected assaulted by strangers (p=0.001),
where the most common lesion were localized at the extremities (p=0,004).
From a radiological point of view (Tab.
V and VI),
it is not possible to find purely radiological unique pattern of domestic violence (51% sensitivity of radiological,
Specificity 64%),
but simultaneous presence of old and new fractures (Sens 20,5%; Spec 100%; PPV 100%; NPV 56%) and the presence of nasal bones broken (Sens 33%; Spec 93,5%; PPV 83,3%; NPV 59%) can distinguish IPV to intentional trauma due to unknown aggressors.
A combined analysis of different pattern has also been perfomed.
The most specific feature found were the presence of old fractures or exostoses together with a swelling of the soft tissues of the face (Sens 10,3%; Spec 100%; PPV 100%; NPV 50,4%) or the combination of lesions in the bones of the face and extremities (Sens 3,9%; Spec 100%; PPV 100%; NPV 50,4%)