Abstract—Background: Elder abuse is under-recognized
by emergency department (ED) providers, largely due to
challenges distinguishing between abuse and accidental
trauma. Objective: To describe patterns and circumstances
surrounding elder abuse-related and potentially abuserelated
injuries in ED patients independently known to be
physical elder abuse victims. Methods: ED utilization of
community-dwelling victims of physical elder abuse in New
Haven, CT from 1981–1994 was analyzed previously. Cases
were identified using Elderly Protective Services data
matched to ED records. Sixty-six ED visits were judged to
have high probability of being related to elder abuse and
244 were of indeterminate probability. We re-examined these
visits to assess whether they occurred due to injury. We identified
and analyzed in detail 31 injury-associated ED visits
from 26 patients with high probability of being related to
elder abuse and 108 visits from 57 patients with intermediate
probability and accidental injury. Results: Abuse-related
injuries were most common on upper extremities (45% of
visits) and lower extremities (32%), with injuries on head
or neck noted in 13 visits (42%). Bruising was observed in
39% of visits, most commonly on upper extremities. Fortytwo
percent of purportedly accidental injuries had suspicious
characteristics, with the most common suspicious
circumstance being injury occurring more than 1 day prior
to presentation, and the most common suspicious injury
pattern being maxillofacial injuries. Conclusion: Victims of
physical elder abuse commonly have injuries on the upper
extremities, head, and neck. Suspicious circumstances and
injury patterns may be identified and are commonly present