An Investigation into a Large, Suburban, Academic Hospital’s Sexual Assault Response Program

This study aims to profile sexual assault (SA) patients, their hospital encounters, and to identify resources necessary for effective management. It is a descriptive, retrospective chart review of all patients >18 who presented to the emergency department with a diagnosis of sexual assault or rape between January 1, 2015 and July 1, 2024. Demographics, hospital stay, and assault characteristics were extracted from patients’ medical records. Odds ratios were calculated with logistic regression models. P-value of <0.05 was considered significant. 309 patients were included, majority of whom were female (89.0%), White (65.3%), and non-Hispanic (76.1%). Nearly all patients requested a SAFE exam (86.1%), and 10.5% left before arrival of the SAFE examiner. Law enforcement was involved in 43.0% of the cases. Many patients (37.5%) had pre-existing psychiatric comorbidity; 18.8% with depression and 7.1% with PTSD. Records showed 10.4% of assaults occurred in a group home, nursing facility, rehab facility, or shelter. Patients with psychiatric history had 0.40 times the crude odds of requesting a SAFE exam, and 0.38 times the crude odds of obtaining HIV testing compared to their counterparts. Patients with no known relationship with their assailant had 2.53 times adjusted odds of completing a sexual offense evidence kit compared to those with a known relationship with their assailant. This study highlights the importance of offering mental health resources and group/nursing home support from the emergency department (ED). This study illustrates focus areas for in-hospital interventions of SA-response programs and provides deeper understanding of SA patients for ED physicians.