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Physical exams are unreliable for detecting all injuries in geriatric trauma patients. Pan Scan (PS) CT imaging is crucial for comprehensive injury identification and finding incidental conditions in elderly individuals.

Keywords:
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Area of Science:

  • Trauma care
  • Geriatric medicine
  • Diagnostic imaging

Background:

  • Elderly patients present pain and physical findings differently, leading to higher mortality and complications.
  • Physical examination (PE) may be unreliable for comprehensive injury identification in geriatric patients.
  • Incidental radiologic findings in this population require quantification.

Purpose of the Study:

  • To evaluate the reliability of physical exam versus computed tomography (CT) for identifying injuries in geriatric trauma patients.
  • To quantify significant incidental radiologic findings in this demographic.
  • To support the use of Pan Scan (PS) CT in geriatric trauma care.

Main Methods:

  • Instituted a policy of Pan Scan (PS) CT for trauma activations in patients aged 65 years and older.
  • PS included CT scans of the head/neck and chest/abdomen/pelvis.
  • Extracted and analyzed physical exam and imaging findings from physician reports.

Main Results:

  • 50% of geriatric trauma patients had clinically significant CT traumatic findings.
  • 25% of significant CT findings were not identifiable on physical exam (p < 0.001).
  • 57.7% of patients had clinically significant incidental findings on PS CT.

Conclusions:

  • Physical examination alone is insufficiently sensitive for detecting all traumatic injuries in elderly patients.
  • Pan Scan (PS) CT offers the added benefit of identifying important incidental findings.
  • These findings support the use of PS CT to optimize care for geriatric trauma patients.