PHOENIX -- Intimate partner violence may negatively impact clinical outcomes and disproportionately affect gender-diverse patients, according to data presented at the Orthopaedic Trauma Association Annual Meeting.

"The important thing is for surgeons to know their population," Natalie Fleming, MSW, RSW, research coordinator in the department of surgery at McMaster University, told Healio. "First, to know that gender diversity exists in their population and that they would be experiencing intimate partner violence differently at different rates. Also, to know that patients who seem completely normal might be going home to a situation that is radically different than what you would expect. That could be affecting things like why they are weight-bearing too early or why they missed their appointments or they have not been taking their pain medication."

Fleming and colleagues prospectively collected data from 314 adults (57.6% women; average age, 47.4 years) who presented for the first time to one of two academic hospital fracture clinics with orthopedic injuries.

Outcome measures included patient-reported experiences with intimate partner violence, [Patient-Reported Outcomes Measurement Information System (PROMIS)] return to function and global health scores, and timing to disclosure of intimate partner violence event.

Overall, Fleming and colleagues found 35% of men and 46% of women reported experiencing any form of intimate partner violence. Fleming said 100% of patients who identified as gender-diverse (gender nonbinary or identify as a different gender than they were assigned at birth) reported experiencing intimate partner violence. In addition, Fleming said 80% of women disclosed an incidence of intimate partner violence at their first opportunity, while men only did so 50% of the time.

In terms of return to function, Fleming said that disclosing intimate partner violence was associated with a 36% lower rate of returning to preinjury level of function overall and a 45% lower rate of returning to preinjury level of function at work if the patient was employed prior to the injury. Fleming also said 5% of patients reported experiencing ongoing intimate partner violence during the study period.

"Our upcoming research is about the addition of a social worker to the fracture clinic that could help people with that aspect of recovery," Fleming told Healio. "The job loss that might happen, loss of income and pain management issues that might tip over into substance abuse issues -- all of those things that happen after orthopedic trauma. We are going to see if putting a dedicated professional in the clinic can take some of that weight off of the surgeon's plate and also help patients."