The Utility of Pan-Scan Imaging in Older Patients After Ground-Level Falls: A Comparative Study

Area of Science:

• Emergency Medicine
• Radiology
• Geriatric Medicine

Background:

• Ground-level falls in older adults necessitate diagnostic imaging.
• Evaluating the efficacy of pan-scan versus selective CT (SCT) protocols is crucial.

Purpose of the Study:

• To compare the outcomes of pan-scan versus SCT in older adults (65+) following ground-level falls.
• To determine the impact of imaging strategy on hospital length of stay, interventions, and incidental findings.

Main Methods:

• Retrospective cohort study involving 203 patients aged 65+.
• Patients received either SCT (head, cervical spine, one additional scan) or pan-scan (head, entire spine, chest, abdomen/pelvis).

Main Results:

• Pan-scan led to more consultations for incidental findings (P=0.020) and significantly more operative interventions (43.9% vs 18.1%; p<0.001).
• SCT resulted in a shorter hospital stay (4.0 vs 6.0 days; p=0.001) with no difference in mortality.
• Multivariable analysis indicated pan-scan independently increased hospital length of stay (R2=0.603).

Conclusions:

• Utilizing physical examination to guide diagnostic imaging reduces unnecessary CT scans in older adults post-fall.
• This approach may decrease hospital length of stay without compromising patient outcomes.
• Selective CT protocols are a more efficient imaging strategy for this patient population.