The comparison of assault and falling in elder patients over 65 years of age
1Department of Emergency, Faculty of Medicine, Bolu Abant Izzet Baysal University, 14030 Bolu, Turkey
DOI: 10.22514/sv.2021.090 Vol.17,Issue 6,November 2021 pp.131-135
Submitted: 01 February 2021 Accepted: 26 March 2021
Published: 08 November 2021
Objective: The aim of the present study was to determine suspected events for elder abuse, and to increase awareness of the clinicians by comparing traumatic elder abuse and falling.
Methods: The study was conducted retrospectively on individuals older than 65 years referred due to traumatic abuse and falling between 1 June 2014 and 30 September 2019. The patients were evaluated for age, gender, co-morbidity, trauma location, trauma scores at referral [injury severity score (ISS), Glasgow coma scale (GCS)], and vital parameters at referral [mean arterial pressure (MAP), and the pulse rate]. Variable distribution was evaluated by Kolmogorov-Simirnov test. Mann Whitney U test was used for analysis of quantitative data; chi-square test was utilized for analysis of independent qualitative data; Fischer’s test was used when chi-square conditions are provided.
Results: The median age of the patients exposed to abuse was 73 (IQR: 11) years and 48% of these patients were male. The age median of the patients exposed to abuse was significantly higher; frequency of female patients were significantly more (p < 0.05). Fracture incidence was higher in the patients who have fallen; however, soft tissue trauma was higher in the patients who have been abused (p < 0.05). Hospitalization prevalence of assaulted cases was higher (p < 0.05); however, mortality prevalence was similar (p ＞ 0.05).
Conclusion: Consequently, abuse causes severe traumas when compared with accident and falling. The probability of abuse should be considered in elder trauma cases with specific locations (upper limbs and face etc.).
Elder patient; Elder abuse; Trauma; Emergency
Kaan Celik,Tamer Colak. The comparison of assault and falling in elder patients over 65 years of age. Signa Vitae. 2021. 17(6);131-135.
 Switzer JA, Michienzi AE. Elder abuse: an update on prevalence, identification, and reporting for the orthopaedic surgeon. The Journal of the American Academy of Orthopaedic Surgeons. 2012; 20: 788–794.
 Evans CS, Hunold KM, Rosen T, Platts-Mills TF. Diagnosis of elder abuse in U.S. emergency departments. Journal of the American Geriatrics Society. 2017; 65: 91–97.
 Murphy K, Waa S, Jaffer H, Sauter A, Chan A. A literature review of findings in physical elder abuse. Canadian Association of Radiologists Journal. 2013; 64: 10–14.
 Statistics Canada. Family violence in Canada: a statistical proﬁle. 2009. Available at: http://www.statcan.gc.ca/pub/85-224-x/85- 224-x2010000-eng.pdf (Accessed: 20 December 2019).
 Kılıç Öztürk Y, Düzenli E, Karaali C, Öztürk F. Physical violence among elderly: analysis of admissions to an emergency department. Turkish Journal of Trauma & Emergency Surgery. 2017; 23: 56–60.
 Dong X, Simon M, De Leon CM, Fulmer T, Beck T, Hebert L, et al. Elder self-neglect and abuse and mortality risk in a community-dwelling population. The Journal of the American Medical Association. 2009; 302: 517–526.
 Stevens TB, Richmond NL, Pereira GF, Shenvi CL, Platts-Mills TF. Prevalence of nonmedical problems among older adults presenting to the emergency department. Academic Emergency Medicine. 2014; 21: 651–658.
 Gowland RL. Elder abuse: evaluating the potentials and problems of diagnosis in the archaeological record. International Journal of Osteoarchaeology. 2016; 26: 514–523.
 Acierno R, Hernandez MA, Amstadter AB, Resnick HS, Steve K, Muzzy W, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the national elder mistreatment study. American Journal of Public Health. 2010; 100: 292–297.
 Rosen T, Bloemen EM, Harpe J, Sanchez AM, Mennitt KW, McCarthy TJ, et al. Radiologists’ training, experience, and attitudes about elder abuse detection. American Journal of Roentgenology. 2016; 207: 1210–1214.
 Gironda MW, Nguyen AL, Mosqueda LM. Is this broken bone because of abuse? Characteristics and comorbid diagnoses in older adults with fractures. Journal of the American Geriatrics Society. 2016; 64: 1651–1655.
 Rosen T, Bloemen EM, LoFaso VM, Clark S, Flomenbaum NE, Lachs MS. Emergency department presentations for injuries in older adults independently known to be victims of elder abuse. The Journal of Emergency Medicine. 2016; 50: 518–526.
 Cham GW, Seow E. The pattern of elderly abuse presenting to an emergency department. Singapore Medical Journal. 2000; 41: 571–574.
 Tanrıkulu C, Tanrıkulu Y. Geriatrik popülasyonda travma analizi: kesitsel çalışma. Yeni Tıp Dergisi. 2013; 30: 100–104. (In Turkish)
 Santos CMD, De Marchi RJ, Martins AB, Hugo FN, Padilha DMP, Hilgert JB. The prevalence of elder abuse in the Porto Alegre metropolitan area. Brazilian Oral Research. 2013; 27: 197–202.
 Frazão SL, Silva MS, Norton P, Magalhães T. Domestic violence against elderly with disability. Journal of Forensic and Legal Medicine. 2014; 28: 19–24.
 Lachs MS, Pillemer K. Elder abuse. Lancet. 2004; 364: 1263–1272.
 Dong X, Simon MA. Association between elder self-neglect and hospice utilization in a community population. Archives of Gerontology and Geriatrics. 2013; 56: 192–198.
 Dong XQ. Elder abuse: systematic review and implications for practice. Journal of the American Geriatrics Society. 2015; 63: 1214–1238.
 Kaldirim U, Tuncer SK, Ardic S, Tezel O, Eyi YE, Arziman I, et al. Analysis of elderly patients presenting to the emergency department via ambulance. Turkish Journal of Emergency Medicine. 2013; 13: 161–166.
 Fisher BS, Regan SL. The extent and frequency of abuse in the lives of older women and their relationship with health outcomes. The Gerontologist. 2006; 46: 200–209.
 Kandiş H, Karakuş A, Katirci Y, Karapolat S, Kara IH. Geriatric population and forensic traumas. Turkish Journal of Geriatrics. 2011; 14.
 Abath MDB, Leal MCC, Melo Filho DAD, Marques APDO. Physical abuse of older people reported at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil. Cadernos de Saúde Pública. 2010; 26: 1797–1806.
 Wong NZ, Rosen T, Sanchez AM, Bloemen EM, Mennitt KW, Hentel K, et al. Imaging findings in elder abuse: a role for radiologists in detection. Canadian Association of Radiologists Journal. 2017; 68: 16–20.
 Kara H, Bayir A, Ak A, Akinci M, Tufekci N, Degirmenci S, et al. Trauma in elderly patients evaluated in a hospital emergency department in Konya, Turkey: a retrospective study. Clinical Interventions in Aging. 2014; 9: 17–21.
 Schofield MJ, Powers JR, Loxton D. Mortality and disability outcomes of self-reported elder abuse: a 12-year prospective investigation. Journal of the American Geriatrics Society. 2013; 61: 679–685.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus: CiteScore 0.5(2021) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.