Outpatient Nasal Bone Fractures: An Under‐Recognized Marker for Domestic Violence
Jenna Rock, Rishi Katragadda, Jamil Hayden, Christopher L. Crafton, Ross Rosen, Alexandra Welschmeyer, Emily R. Youner, Humzah A. Quereshy, Amanda Goslawski, Saikrishna Gourishetti, Cyrus C. RabbaniAbstract
Objective
To assess the risk of a new domestic violence (DV) diagnosis following outpatient presentation for a nasal bone fracture.
Study Design
Retrospective cohort study.
Setting
Multicenter analysis using the TriNetX research database.
Methods
Female patients aged 18 to 60 years were identified by ICD‐10 codes. Propensity‐matched analyses compared the risk of subsequent DV diagnosis among patients with nasal bone fractures versus (1) patients with other facial fractures and (2) the general population.
Results
Among 24,757 patients with nasal bone fractures, 3.55% were later diagnosed with DV compared with 0.57% in the general population and 2.66% in patients with other facial fractures. Relative risk of DV was 6.18 (95% CI, 5.18‐7.38) compared with the general population and 1.34 (95% CI, 1.21‐1.48) compared with other facial fractures ( P < .001). Black and Hispanic women with nasal bone fractures had the highest rates of DV diagnosis (6.85% and 4.20%, respectively) and relative risk compared with the general population (8.55 and 6.88, respectively).
Conclusion
Outpatient presentation with a nasal bone fracture is associated with more than a sixfold increased risk of subsequent DV diagnosis. Early DV screening and referral protocols in outpatient settings may help identify at‐risk individuals and provide timely support.