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

This study aimed to determine injury patterns in ground level falls (GLFs) and investigate the effect of age on the severity of injury.

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.

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.

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.