Interpersonal violence and violent re‐injury in the Northern Territory

Abstract

Objectives To analyse incidence of prior emergency department presentations for interpersonal violence and demographics for a series of hospital admissions for interpersonal violence injuries. Design Retrospective analysis of trauma registry. Setting A tertiary hospital and primary referral centre for trauma in the Top End of the Northern Territory. Participants Patients hospitalised from 2010 to 2015 for injuries due to interpersonal violence with an injury severity score > 9. Main outcome measures Patient demographics, injury location, assault mechanism, alleged perpetrator, time/day of event, alcohol involvement, clinical outcome and prior emergency department presentations for interpersonal violence. Results A total of 248 admissions for patients with Injury Severity Score > 9 due to interpersonal violence were identified. Indigenous females over‐represented non‐Indigenous females (35.4% vs 5.0%, P < .001). The majority of victims had evidence of alcohol intake at presentation. Victims of single‐punch head injuries were mostly male and non‐Indigenous, whilst Indigenous persons experienced significantly more blunt and penetrating weapon injuries (66.7% and 68.1%). Forty‐three per cent of patients had a preceding emergency department presentation for interpersonal violence; female gender, Indigenous ethnicity, evidence of alcohol intake, and urban location of injury were independent risk factors for prior interpersonal violence presentation. Conclusions Interpersonal violence is a recurring disease for a just under half of those presenting to a Top End hospital with moderate to severe injuries. Indigenous ethnicity, female gender and evidence of alcohol intake are predictive of prior interpersonal violence presentations. Patient under‐reporting and incomplete data may underestimate the true prevalence of interpersonal violence presentations in rural and remote locales.

Complex early childhood experiences: Characteristics of Northern Territory children across health, education and child protection data

“…In remote areas, there were an average of 202 incidents per 1000 population, compared to average of 782 per 1000 population in urban areas [ 117 ]. Furthermore, a retrospective analysis of data specific to Royal Darwin Hospital (the sole trauma referral centre in the NT), from the Australia New Zealand Trauma Registry found that in the NT, being injured from intimate partner violence in an urban or remote, as opposed to very remote, location carried higher odds of previous presentations with intimate partner violence [ 118 ].…”

“…The completeness of reporting of events is also an important factor when considering the non - attenders cluster, as data collection may be limited by service availability if the regions with poorer school attendance also have a more general limit on services including fewer potential CPS reporters. It has been suggested that intimate partner violence, for instance, may be under-reported in very remote settings [ 118 ]. This is less likely in the case of child maltreatment, firstly given NT mandatory reporting laws require every person in the NT to report child abuse or neglect, and secondly given the transparency provided by communal living in remote communities, it is likely that most maltreated children will be recorded, even if not every event [ 86 ].…”

Recidivism after orthopaedic trauma has diminished over time

“…Ramifications, in addition to recidivism, include lower rates of employment, greater risks for complications, more chronic pain, and lower patient satisfaction among patients with pre-existing mental illness [ 4 , 20 , 23 – 29 ]. Resources to treat this patient population are lacking in most trauma systems, and this remains a major public health issue [ 5 , 14 , 17 , 30 – 38 ].…”

“…Trauma patients have been shown to exhibit recidivism frequently, resulting in new traumatic injuries, seen in subsequent visits to emergency rooms [ 1 – 5 ]. These visits and resultant hospital admissions generate substantial medical and interpersonal costs.…”

Analysis of Injury Characteristics in Victims of Interpersonal Violence: Clinical Forensic Medicine Unit Perspective in a Tertiary Care Centre

“…The integrative review by Carvalho AP et al 13 included 19 studies and showed that alcohol consumption is the predictor of physical violence in the perpetrator and for the adolescent victim of the violence. Lim KHA et al 12 found that majority of the victims of IPV presented to the emergency department had a history of alcohol intake. Blunt force or impact injuries (lacerations at 43.12%, contusion at 31.87% and abrasion at 27.5%) were the commonest in the patients of IPV in the current study.…”