Comparison of patients diagnosed with intimate partner violence with and without brain injury: Retrospective cross-sectional study in a single, urban, academic health system, 2016-2025.
- 1Rush University Medical Center
Abstract
BackgroundBrain injury (BI) in people who have experienced intimate partner violence (IPV) is underdiagnosed in health care settings. Our project aims to determine how the prevalence and characteristics of people with documented IPV+BI differ from people with IPV alone.
MethodsA retrospective cross-sectional study was conducted using electronic health record data at Rush University Medical Center (2016-2025). Adults aged 18 years or older were classified into two groups: IPV with brain injury (IPV+BI) and IPV without brain injury (IPV). Demographics, injury patterns, comorbidities, and pre-diagnosis healthcare utilization between cohorts were compared.
ResultsIn 1,329,460 adult patients from 2016 to 2025 seen at Rush, 2,816 were diagnosed with IPV (prevalence = 0.21%). Also, 486 were concomitantly diagnosed with IPV+BI (17.2% of the IPV population). Most (71%) of initial diagnosis documentation occurred in an Emergency Room encounter. Alcohol use disorder, anemia, chronic liver disease, and vascular diseases were more common in the IPV+BI cohort, compared to IPV alone. Prior to diagnosis, the IPV+BI cohort utilized significantly more acute care resources but less ambulatory usage.
DiscussionElectronic health record documentation of IPV with and without BI mainly occurred in the Emergency Room and was lower than anticipated. People with IPV+BI were more likely to have certain co-morbidities and were less likely to utilize health resources before diagnosis. The findings, if confirmed utilizing data from multiple health systems in the Chicagoland region, can support work to advance diagnosis and management of IPV+BI.
KEYPOINTSO_LIIn 1,329,460 adult patients from 2016 to 2025 seen at Rush, 2,816 were diagnosed with IPV (prevalence = 0.21%) which is lower than reported from public health datasets. C_LIO_LIAlso, 486 were concomitantly diagnosed with IPV+BI (17.2% of the IPV population). C_LIO_LIThe IPV and IPV+BI were initially documented during an emergency room encounter (71% overall, 68% for IPV alone and 93% for IPV+BI) with injury type mainly being unspecified or other head injury rather (74%) rather than traumatic brain injury or strangulation. C_LIO_LIIn the IPV+BI cohort, alcohol use disorder, anemia, chronic liver disease, and vascular diseases were significantly more common than the IPV alone. C_LIO_LIBefore diagnosis, the IPV+BI cohort utilized more acute care but lacked ambulatory usage. C_LI
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BibTeX
@misc{tsai2026comparison,
title = {{Comparison of patients diagnosed with intimate partner violence with and without brain injury: Retrospective cross-sectional study in a single, urban, academic health system, 2016-2025.}},
author = {C.-C. Tsai and D. Kozlowski and S. V. Crabtree-Nelson and D. Sedillo and S. Hoffman Binder and E. McClerkin and M. Pitzele and R. Fitzgerald and R. C. Shah},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.21.26366030},
url = {https://www.medrxiv.org/content/10.64898/2026.10.21.26366030v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Comparison of patients diagnosed with intimate partner violence with and without brain injury: Retrospective cross-sectional study in a single, urban, academic health system, 2016-2025.
AU - C.-C. Tsai
AU - D. Kozlowski
AU - S. V. Crabtree-Nelson
AU - D. Sedillo
AU - S. Hoffman Binder
AU - E. McClerkin
AU - M. Pitzele
AU - R. Fitzgerald
AU - R. C. Shah
PY - 2026
DA - 2026/10/21
PB - medRxiv
DO - 10.64898/2026.10.21.26366030
UR - https://www.medrxiv.org/content/10.64898/2026.10.21.26366030v1
AB - BackgroundBrain injury (BI) in people who have experienced intimate partner violence (IPV) is underdiagnosed in health care settings. Our project aims to determine how the prevalence and characteristics of people with documented IPV+BI differ from people with IPV alone. MethodsA retrospective cross-sectional study was conducted using electronic health record data at Rush University Medical Center (2016-2025). Adults aged 18 years or older were classified into two groups: IPV with brain injury (IPV+BI) and IPV without brain injury (IPV). Demographics, injury patterns, comorbidities, and pre-diagnosis healthcare utilization between cohorts were compared. ResultsIn 1,329,460 adult patients from 2016 to 2025 seen at Rush, 2,816 were diagnosed with IPV (prevalence = 0.21%). Also, 486 were concomitantly diagnosed with IPV+BI (17.2% of the IPV population). Most (71%) of initial diagnosis documentation occurred in an Emergency Room encounter. Alcohol use disorder, anemia, chronic liver disease, and vascular diseases were more common in the IPV+BI cohort, compared to IPV alone. Prior to diagnosis, the IPV+BI cohort utilized significantly more acute care resources but less ambulatory usage. DiscussionElectronic health record documentation of IPV with and without BI mainly occurred in the Emergency Room and was lower than anticipated. People with IPV+BI were more likely to have certain co-morbidities and were less likely to utilize health resources before diagnosis. The findings, if confirmed utilizing data from multiple health systems in the Chicagoland region, can support work to advance diagnosis and management of IPV+BI. KEYPOINTSO_LIIn 1,329,460 adult patients from 2016 to 2025 seen at Rush, 2,816 were diagnosed with IPV (prevalence = 0.21%) which is lower than reported from public health datasets. C_LIO_LIAlso, 486 were concomitantly diagnosed with IPV+BI (17.2% of the IPV population). C_LIO_LIThe IPV and IPV+BI were initially documented during an emergency room encounter (71% overall, 68% for IPV alone and 93% for IPV+BI) with injury type mainly being unspecified or other head injury rather (74%) rather than traumatic brain injury or strangulation. C_LIO_LIIn the IPV+BI cohort, alcohol use disorder, anemia, chronic liver disease, and vascular diseases were significantly more common than the IPV alone. C_LIO_LIBefore diagnosis, the IPV+BI cohort utilized more acute care but lacked ambulatory usage. C_LI
ER -