Falls From Sitting to Standing

Background: When evaluating trauma patients, many centers perform computed tomography of the head, cervical spine, chest, abdomen, and pelvis, the so-called "pan-scan." Here, we evaluate the utility of pan-scan in geriatric patients who sustained ground-level falls.

Study Design: We performed a retrospective review of consecutive patients from the trauma registry of a large, urban Level 1 trauma center. Inclusion criteria were registration during the 2019 calendar year, age ≥ 65, mechanism of fall from either sitting or standing, and performance of "pan-scan" at time of assessment. Patient demographics, physical exam findings, CT results, injuries, and patient disposition were recorded. The sensitivity, specificity, positive and negative predictive values of the physical exam for significant injuries were calculated.

Study Overview

• Status: Completed
• Conditions: Falls, Tomography of the Head, Cervical Spine, Chest, Abdomen, and Pelvis
• Intervention / Treatment: Diagnostic test: tomography pan scan

• Study Type: Observational
• Enrollment (Actual): 751

Contacts and Locations

Study Locations

• United States
  • New York
    • New York, New York, United States, 10305
      • SIUH Northwell Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 63 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A retrospective chart review was conducted using the trauma registry at a large, urban Level 1 trauma center. This registry was queried for consecutive elderly patients (age >65 years) who presented with fall from sitting or standing from 01/01/2019-12/31/2019. This trauma registry includes all patients of which the trauma surgery team was notified as part of the insinuation's trauma notification protocol. It also includes patients who were ultimately admitted to the hospital with ICD 10 codes consistent with traumatic injuries, regardless of trauma team activation. Patients discharged from the Emergency Department with a traumatic injury may have limited data in the registry.

Description

Inclusion criteria

• age >65
• presented with fall from sitting or standing from 01/01/2019-12/31/2019

Exclusion criteria included

• age <65 years,
• falls from height,
• GCS less than 14,
• patients who did not undergo the complete pan-scan.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Retrospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensitivity of physical exam compared to CT scan and identifying traumatic injuries	Sensitivity of physical exam compared to CT scan and identifying traumatic injuries. Sensitivity is a statistical measure which was calculated using our SAS software as described in methods. CT scan was used as the gold standard. Both physical exam and CAT scan were performed on initial presentation with a time frame on the order of minutes to hours.	2 years
Prevalence of injury.	Traumatic injuries were determined by CT scan, tabulated, and broken down by body region as well as injury type. These data were collected at the time of CT scan on initial presentation. These data presented as whole numbers and percentages.	2 years
Disposition from ED	Dispositions were determined by chart review, tabulated, and broken down by disposition location. These data collected at the time of admission	2 years
Disposition from hospital.	Dispositions were determined by chart review, tabulated, and broken down by disposition location, including patient expiration in some cases. These data were collected at the time of discharge	2 years

Collaborators and Investigators

• Sponsor: Northwell Health

Study record dates

Study Major Dates

• Study Start (Actual): October 6, 2020
• Primary Completion (Actual): May 9, 2022
• Study Completion (Actual): May 9, 2022

Study Registration Dates

• First Submitted: May 23, 2022
• First Submitted That Met QC Criteria: June 6, 2022
• First Posted (Actual): June 7, 2022

Study Record Updates

• Last Update Posted (Actual): June 7, 2022
• Last Update Submitted That Met QC Criteria: June 6, 2022
• Last Verified: June 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: 20-0850 SIUHN

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: aggregate data will be published

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No