Utility of Torso Imaging for Elderly Patients Sustaining Ground-Level Falls

Area of Science:

• Emergency Medicine
• Radiology
• Geriatric Trauma

Background:

• Computed tomography (CT) of the torso is increasingly used for fall patients.
• Older adults (≥65) may benefit more from torso imaging than younger patients.
• This study evaluates CT usage and utility in elderly patients after ground-level falls (GLFs).

Purpose of the Study:

• To assess the association between age and the identification of traumatic injuries via torso CT in ground-level fall patients.
• To determine if elderly patients (≥65) have a higher likelihood of injury detection with torso CT compared to younger patients.
• To evaluate the utility of torso CT in identifying injuries not apparent on physical exam or plain radiography after GLFs.

Main Methods:

• Retrospective review of patients (≥18) experiencing GLFs between 2015-2019.
• Comparison of CT imaging utilization and injury identification rates between patients <65 and ≥65 years old.
• Multivariate logistic regression models analyzed the association between age and traumatic injury identification after torso CT.

Main Results:

• Older patients received more screening radiographs and head/neck CTs, but not torso CTs.
• Age was not significantly associated with increased identification of traumatic injury on torso CT.
• A positive physical exam was the only variable significantly associated with abnormal torso CT findings.

Conclusions:

• Torso CT injury identification in GLF patients is not age-dependent but strongly linked to physical exam findings.
• Conservative use of torso CT in elderly GLF patients with negative physical exams can reduce costs without compromising care.
• Targeting CT imaging based on physical exam findings can optimize resource utilization in geriatric trauma.