A retrospective cohort study to determine the injury prevalence sustained from elderly patients undergoing full trauma CT

Abstract text (incl. references and figure legends)

Study Aim: The aim of the study was to determine the prevalence of injuries and injury patterns in elderly patients (>65 years) with low level falls who underwent a full trauma series.

Introduction: The Emergency Department at North Manchester General Hospital is a non- trauma centre but see a significant number of elderly fallers. Our previous experience has shown that many of the patients have significant orthopaedic injuries often with few signs or symptoms. The aim of this retrospective cohort study was to determine the injury prevalence and injury patterns in elderly patients either from low level falls,

Methodology: The CT scan reports and clinical notes were reviewed of all elderly patients (over 65 years of age) who had a full trauma CT (head, neck, chest, abdomen and pelvis) over a twelve-month period (September 2020–September 2021). The indications for performing a full trauma CT rather than selective CT (e.g. head and neck) at our institution is based upon the following:- haemodynamic instability, signs of multisystem injury or clinical suspicion of injury in more than one anatomical area.

Results: Sixty-six elderly patients underwent a full trauma series over the twelve-month period. The mean age of the cohort was 83.2 years, 39% (n=26) of the patients were identified to have a least one injury detected on CT scan. 86% (n=57) were due to ground level falls. The remaining cases were made up of patients falling down steps or stairs (n=5) or low speed road traffic accidents (n=4). In total 12% of patients sustained two or more rib fractures, with or without an associate heamopneumothorax. The remaining injuries were orthopaedic in nature (long bone, pelvic or spinal fractures).

Conclusion. The results of this study justified a fairly liberal approach to the use of the full trauma CT in elderly patients. Elderly patients may have few signs or symptoms despite having significant injuries which were found to be are predominantly orthopaedic in nature.

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