Falls, Tomography of the Head, Cervical Spine, Chest, Abdomen, and Pelvis
Conditions
Brief summary
Background: When evaluating trauma patients, many centers perform computed tomography of the head, cervical spine, chest, abdomen, and pelvis, the so-called pan-scan. Here, we evaluate the utility of pan-scan in geriatric patients who sustained ground-level falls. Study Design: We performed a retrospective review of consecutive patients from the trauma registry of a large, urban Level 1 trauma center. Inclusion criteria were registration during the 2019 calendar year, age ≥ 65, mechanism of fall from either sitting or standing, and performance of pan-scan at time of assessment. Patient demographics, physical exam findings, CT results, injuries, and patient disposition were recorded. The sensitivity, specificity, positive and negative predictive values of the physical exam for significant injuries were calculated.
Interventions
DIAGNOSTIC_TESTtomography pan scan
This is a retrospective chart review
Sponsors
Northwell Health
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age \>65 * presented with fall from sitting or standing from 01/01/2019-12/31/2019
Exclusion criteria
included * age \<65 years, * falls from height, * GCS less than 14, * patients who did not undergo the complete pan-scan.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of physical exam compared to CT scan and identifying traumatic injuries | 2 years | Sensitivity of physical exam compared to CT scan and identifying traumatic injuries. Sensitivity is a statistical measure which was calculated using our SAS software as described in methods. CT scan was used as the gold standard. Both physical exam and CAT scan were performed on initial presentation with a time frame on the order of minutes to hours. |
| Prevalence of injury. | 2 years | Traumatic injuries were determined by CT scan, tabulated, and broken down by body region as well as injury type. These data were collected at the time of CT scan on initial presentation. These data presented as whole numbers and percentages. |
| Disposition from ED | 2 years | Dispositions were determined by chart review, tabulated, and broken down by disposition location. These data collected at the time of admission |
| Disposition from hospital. | 2 years | Dispositions were determined by chart review, tabulated, and broken down by disposition location, including patient expiration in some cases. These data were collected at the time of discharge |
Countries
United States
Outcome results
None listed