Patients with falls from standing height and head or neck injury may not require body CT in the absence of signs or symptoms of body injury

Baig, Asad; Drabkin, Michael J.; Khan, Fiza; Fogel, Joshua; Shah, Salman

doi:10.1007/s10140-020-01843-9

Cited by 2 publications

(5 citation statements)

References 20 publications

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“…[ 20 ] Possible causes of injury susceptibility in the elderly patients are decreased muscle tone, decreased bone density, and physical inactivity that deteriorate with age. [ 1 , 14 ] Spaniolas et al reported that, in the elderly (>70 years), GLF was statistically significantly more mortal. Long bone fractures, pelvic fractures, and intracranial injuries were significantly higher in the elderly group.…”

Section: Discussionmentioning

confidence: 99%

“…According to the World Health Organization, falls are the second greatest reason for accidental or unintentional injury in the world, after motor vehicle accidents. [ 1 , 2 ] A ground level fall (GLF) is a low-energy form of trauma that can occur in all age groups, but it is the most common mechanism of trauma in geriatric patients. GLF can cause serious injuries including fractures and intracranial and spinal cord injuries in the elderly compared with the younger patients.…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography (CT) is an important diagnostic method to be used in the triage and treatment of trauma patients. [ 1 , 3 - 5 , 9 ] CT protocols in trauma differ between health-care centers. While some prefer a whole-body CT (WBCT) scan for each trauma patient, others focus on certain body parts according to the type of trauma, the patient’s clinical condition, and physical examination (PE) findings.…”

Section: Introductionmentioning

confidence: 99%

“…While some prefer a whole-body CT (WBCT) scan for each trauma patient, others focus on certain body parts according to the type of trauma, the patient’s clinical condition, and physical examination (PE) findings. [ 1 , 3 - 5 , 9 ] Some meta-analyses comparing WBCT and selective CT suggest that the former is associated with better outcomes, such as lower mortality rates. [ 10 , 11 ] However, it is stated that especially in low-energy traumas such as GLF, selective CT scanning according to PE findings would be sufficient in the diagnosis of injuries, and this would protect the patient from unnecessary radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

“…[ 10 , 11 ] However, it is stated that especially in low-energy traumas such as GLF, selective CT scanning according to PE findings would be sufficient in the diagnosis of injuries, and this would protect the patient from unnecessary radiation exposure. [ 1 , 12 , 13 ] It should be kept in mind that the intravenous contrast agent to be used especially for abdominal CT may deteriorate the already decreased renal functions in elderly patients, as well as incurring additional costs. [ 12 - 14 ] Therefore, CT should be used considering the benefits and risks for each patient.…”

Section: Introductionmentioning

confidence: 99%

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Ground level falls: computed tomography findings and clinical outcomes by age groups

Parlak

Çıvgın

Beşler

et al. 2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: This study aimed to determine injury patterns in ground level falls (GLFs) and investigate the effect of age on the severity of injury. METHODS: We retrospectively identified 4,712 patients who presented to a Level 1 trauma center due to GLFs and analyzed the data of 1,214 patients who underwent computed tomography (CT). Demographics, torso examination findings, and injuries detected on CT were recorded. To investigate the effect of age on injury severity, the patients were grouped as those aged <65 and ≥65 years. RESULTS: The mean age was 57 years, and 55.20% of the patients were female. The mortality rate was 0.50%. Injury was detected in 489 (40.30%) patients on CT. Fractures were the most common injury type. Traumatic intracranial hemorrhage was detected in 32 (2.60%) patients. Only three (0.20%) of the 63 patients with rib fractures had concomitant lung injury. The negative predictive value of the physical examination (PE) was 95.80% for chest injury. Intra-abdominal injury was not detected in any of the 116 patients who underwent abdominal CT. Hospitalization was also higher in the ≥65-year group (p<0.001). All mortalities (n=6) were seen in patients aged ≥65 years. CONCLUSION: Our results indicate that GLFs cause more injuries in the elderly, resulting in more hospitalizations and mortality. Normal PE findings may reduce the need for whole-body CT in GLF patients who are conscious, cooperative, and oriented.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ground level falls: computed tomography findings and clinical outcomes by age groups

Parlak

Çıvgın

Beşler

et al. 2023

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

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Time trend analysis of Injury Severity score of adult trauma patients with emergent CT examination

Neef,

Meinel,

Lorbeer

et al. 2024

Emerg Radiol

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Purpose Controversy exists about whole-body computed tomography (CT) as a primary screening modality for suspected multiple trauma patients. Therefore, the aim of this study was to analyze time trends of CT examinations for trauma patients in relation to the Injury Severity Score (ISS). Methods We retrospectively analyzed 561 adult trauma patients (mean age = 54 years) who were admitted to the trauma room of our hospital, immediately followed by a CT examination, in 2009, 2013 und 2017. Review of electronic patient charts was performed to determine the cause of injury. ISS was either calculated upon hospital charts and CT imaging reports or documented in the TraumaRegister DGU® for trauma patients with ICU treatment or ISS ≥ 16. Results An increasing number of CT examinations of acute trauma patients were performed at our hospital with 117 patients in 2009 compared to 192 in 2013 and 252 in 2017. Their mean age increased (50 years in 2009, 54 in 2013 and 55 in 2017;p = 0.046), whereas their mean ISS decreased over time (15.2 in 2009 compared to 12.1 in 2013 and 10.6 in 2017;p = 0.001), especially in women (15.1 in 2009, 11.8 in 2013 and 7.4 in 2017;p = 0.001 both), younger age groups (18 to 24 years:15.6 in 2009, 6.5 in 2013 and 8.9 in 2017; p = 0.033 and 25 to 49 years:15.0 in 2009, 11.2 in 2013 and 8.3 in 2017;p = 0.001) as well as motor vehicle collision (MVC) victims (16.2 in 2009, 11.8 in 2013 and 6.1 in 2017; p < 0.001). Trauma patients with a high ISS were especially more likely of older age (OR 1.02,p < 0.001) and with the type of incident being a fall (< 3 m: OR3.84,p < 0.001;>3 m: OR6.22,p < 0.001) compared to MVC. Conclusion Previous studies suggesting a benefit of primary whole-body CT for trauma patients might not reflect the current patient population with decreasing ISS. Especially females, younger age groups and MVC patients might benefit from stricter selection criteria for receiving whole-body CT. Our results also emphasize the importance of prevention of fall or tumble for elderly people.

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Patients with falls from standing height and head or neck injury may not require body CT in the absence of signs or symptoms of body injury

Cited by 2 publications

References 20 publications

Ground level falls: computed tomography findings and clinical outcomes by age groups

Ground level falls: computed tomography findings and clinical outcomes by age groups

Time trend analysis of Injury Severity score of adult trauma patients with emergent CT examination

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