The hanging chin sign as a mortality predictor in geriatric patients at the emergency department: a retrospective cohort study

• Published in: BMC geriatrics 2022-02, Vol.22 (1), p.95-95, Article 95
• Main Authors: Huijgens, Anneloes N J, van Baardewijk, Laurens J, Keijsers, Carolina J P W
• Format: Article
• Language: English
• Subjects: Aged; Aged patients; Care and treatment; Chest; Chest X-ray; Chin; Cohort analysis; Diagnosis; Electronic health records; emergency department; Emergency medical care; Emergency medicine; Emergency Service, Hospital; Frailty; Geriatric Assessment; geriatric patients; Geriatrics; Hanging chin sign; Hospitals; Humans; Jaw; Kyphosis; Mortality; Older people; Patient outcomes; Patients; Reproducibility of Results; Retrospective Studies; X-rays
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-022-02780-7

At the emergency department, there is a need for an instrument which is quick and easy to use to identify geriatric patients with the highest risk of mortality. The so- called 'hanging chin sign', meaning that the mandibula projects over one or more ribs on the chest X-ray, could be such an instrument. This study aims to investigate if the hanging chin sign is a predictor of mortality in geriatric patients admitted through the emergency department. We performed an observational retrospective cohort study in a Dutch teaching hospital. Patients of ≥65 years who were admitted to the geriatric ward following an emergency department visit were included. The primary outcome of this study was mortality. Secondary outcomes included the length of admission, discharge destination and the reliability compared to patient-related variables and the APOP screener. Three hundred ninety-six patients were included in the analysis. Mean follow up was 300 days; 207 patients (52%) died during follow up. The hanging chin sign was present in 85 patients (21%). Patients with the hanging chin sign have a significantly higher mortality risk during admission (OR 2.94 (1.61 to 5.39), p