United States ED Visits by Adult Women for Nonfatal Intimate Partner Strangulation, 2006 to 2014: Prevalence and Associated Characteristics.

The data are emergency department discharge records, not unique patients, so one woman with several visits could affect the counts. The records are administrative and de-identified, so patient narratives, clinical notes, and many social factors were not available. Strangulation had to be documented and coded to be counted, so missed documentation, variable coding, or patient reluctance to disclose could underestimate the true ED visit frequency. The study used a conservative intimate partner violence code, which may have excluded visits that were related to intimate partner violence but not coded that way. Women who did not seek emergency care are absent from the database, so the findings cannot describe all women who experience strangulation. The study cannot tell whether the rise in coded strangulation visits reflects more strangulation, better recognition, or better coding.

Do not read the 1.2% prevalence as the true rate of U.S. emergency visits for nonfatal intimate partner strangulation. The study is based on administrative codes, and the authors say undercoding, missed documentation, and women not seeking care may make this an underestimate.