Outpatient Nasal Bone Fractures: An Under‐Recognized Marker for Domestic Violence

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.