Pan-body computed tomographic scanning for patients with intracranial hemorrhage after low-energy falls

Am J Surg. 2015 Mar;209(3):521-5. doi: 10.1016/j.amjsurg.2014.12.002. Epub 2014 Dec 15.

Abstract

Background: We sought to determine if a liberal policy of pan-body computerized tomography (CT) scanning was useful in patients with intracranial hemorrhage after low falls.

Methods: Patients with intracranial hemorrhage after low falls, with a Glasgow Coma Score of greater than or equal to 14 and systolic blood pressure of greater than 100 mm Hg, were included. The primary outcome was any torso or spine injury requiring surgical or radiologic intervention. The secondary outcome was any torso or spine injury.

Results: Of 365 patients, 71% underwent pan-body CT. Eight (2%) patients had a primary outcome and 66 (18%) a secondary outcome. Only signs and symptoms of cervical injury were associated with a cervical-related outcome (4/23 vs 3/316, P = .005). Only signs and symptoms of torso injury were associated with a torso-related outcome.

Conclusions: A liberal policy of pan-body CT in these patients is of low yield. Signs and symptoms of trauma should dictate the judicious use of CT.

Keywords: Computerized tomography; Falls; Traumatic intracranial hemorrhage.

MeSH terms

  • Accidental Falls*
  • Aged
  • Brain Injuries / complications
  • Brain Injuries / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Hemorrhages / diagnostic imaging*
  • Intracranial Hemorrhages / etiology
  • Male
  • Reproducibility of Results
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Trauma Centers
  • Trauma Severity Indices
  • Whole Body Imaging / methods*