Relevance of emergency head CT scan for fall in the elderly person

Fall of the elderly person is a public health problem. The objectives of our study were to evaluate the relevance of systematically performing in emergency a computed tomography (CT) scan for fall in the elderly person, to identify specific criteria predicting the appearance of lesions. We performed...

Full description

Saved in:
Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2020-02, Vol.47 (1), p.54-58
Main Authors: Pages, Pierre-Jean, Boncoeur-Martel, Marie-Paule, Dalmay, François, Salle, Henri, Caire, François, Mounayer, Charbel, Rouchaud, Aymeric
Format: Article
Language:English
Subjects:
Emergency
Geriatric
Life Sciences
Neurons and Cognition
Relevance
Traumatic brain injury
X-ray computed tomography
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c442t-c5b954e1ea0ead02fc8008551b6a7ef16358c357295aaaf5c15e253ad5ea29ef3
cites cdi_FETCH-LOGICAL-c442t-c5b954e1ea0ead02fc8008551b6a7ef16358c357295aaaf5c15e253ad5ea29ef3
container_end_page 58
container_issue 1
container_start_page 54
container_title American journal of neuroradiology : AJNR
container_volume 47
creator Pages, Pierre-Jean
Boncoeur-Martel, Marie-Paule
Dalmay, François
Salle, Henri
Caire, François
Mounayer, Charbel
Rouchaud, Aymeric
description Fall of the elderly person is a public health problem. The objectives of our study were to evaluate the relevance of systematically performing in emergency a computed tomography (CT) scan for fall in the elderly person, to identify specific criteria predicting the appearance of lesions. We performed a retrospective analysis of 500 consecutive patients aged 65 and over, who underwent an emergency head CT scan for fall from their height. Outcome at the end of the acute care, clinico-biological data and delays between trauma an d CT were collected, and crossed with a detection of head lesion on the CT scan. Of 500 patients, 38 (7.6%) had traumatic lesions depicted on the CT scan and 267 (53.4%) were hospitalized after the CT scan. Three (0.6%) had been operated for urgent head surgery. Nine of the 38 (23.6%) patients with traumatic lesion returned home. Presence of a lesion depicted on the CT scan was not correlated with the orientation of the patient (P 
doi_str_mv 10.1016/j.neurad.2019.03.004
format article
fullrecord <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_02395523v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0150986118304255</els_id><sourcerecordid>2204693862</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-c5b954e1ea0ead02fc8008551b6a7ef16358c357295aaaf5c15e253ad5ea29ef3</originalsourceid><addsrcrecordid>eNp9kMFKAzEQhoMotlbfQCRHPew6STbp5iLUolYoCFLBW0izs3bLdrcmbaFvb8pqj54GZr7_H_gIuWaQMmDqfpk2uPW2SDkwnYJIAbIT0mdaqERL_XlK-sAkJDpXrEcuQlgCcMYyfk56ArRkQ6X65PEda9zZxiFtS4or9F_YuD1doC3oeEaDsw0tW09LW9e0auhmgRTrAn29p2v0oW0uyVk8Brz6nQPy8fw0G0-S6dvL63g0TVyW8U3i5FzLDBlaiN3AS5cD5FKyubJDLJkSMndCDrmW1tpSOiaRS2ELiZZrLMWA3HW9C1ubta9W1u9NayszGU3NYQdcaCm52LHI3nbs2rffWwwbs6qCw7q2DbbbYDiHTGmRKx7RrEOdb0PwWB67GZiDabM0nWlzMG1AmGg6xm5-P2znKyyOoT-1EXjoAIxOdhV6E1wV3WJReXQbU7TV_x9-AHKtj04</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2204693862</pqid></control><display><type>article</type><title>Relevance of emergency head CT scan for fall in the elderly person</title><source>Open Access: PubMed Central</source><source>Elsevier</source><creator>Pages, Pierre-Jean ; Boncoeur-Martel, Marie-Paule ; Dalmay, François ; Salle, Henri ; Caire, François ; Mounayer, Charbel ; Rouchaud, Aymeric</creator><creatorcontrib>Pages, Pierre-Jean ; Boncoeur-Martel, Marie-Paule ; Dalmay, François ; Salle, Henri ; Caire, François ; Mounayer, Charbel ; Rouchaud, Aymeric</creatorcontrib><description>Fall of the elderly person is a public health problem. The objectives of our study were to evaluate the relevance of systematically performing in emergency a computed tomography (CT) scan for fall in the elderly person, to identify specific criteria predicting the appearance of lesions. We performed a retrospective analysis of 500 consecutive patients aged 65 and over, who underwent an emergency head CT scan for fall from their height. Outcome at the end of the acute care, clinico-biological data and delays between trauma an d CT were collected, and crossed with a detection of head lesion on the CT scan. Of 500 patients, 38 (7.6%) had traumatic lesions depicted on the CT scan and 267 (53.4%) were hospitalized after the CT scan. Three (0.6%) had been operated for urgent head surgery. Nine of the 38 (23.6%) patients with traumatic lesion returned home. Presence of a lesion depicted on the CT scan was not correlated with the orientation of the patient (P &lt; 0.0001). Post-traumatic injury was significantly associated with male sex (RR = 2.19, P = 0.0217), consciousness impairment (RR = 1.56, P &lt; 0.0001), focal neurological deficit (RR = 6.36, P = 0.0362) and past history of post-traumatic brain injury (RR = 7.17, P = 0.0027). Anticoagulant therapy was not associated with increased risk of traumatic lesions (P = 0.3315). ROC analysis determined that a 5-hours time-interval between head trauma and CT allowed optimal detection of lesions. The systematic indication of an emergency head CT scan for fall in elderly patients presents a low diagnostic and therapeutic yield and is not relevant. Male sex, consciousness impairment, focal neurological deficit, past history of post-traumatic brain injury and time-interval between head trauma and CT are statistically related to the presence of lesions and should therefore be taken into account.</description><identifier>ISSN: 0150-9861</identifier><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.1016/j.neurad.2019.03.004</identifier><identifier>PMID: 30951766</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Emergency ; Geriatric ; Life Sciences ; Neurons and Cognition ; Relevance ; Traumatic brain injury ; X-ray computed tomography</subject><ispartof>American journal of neuroradiology : AJNR, 2020-02, Vol.47 (1), p.54-58</ispartof><rights>2019 Elsevier Masson SAS</rights><rights>Copyright © 2019 Elsevier Masson SAS. All rights reserved.</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-c5b954e1ea0ead02fc8008551b6a7ef16358c357295aaaf5c15e253ad5ea29ef3</citedby><cites>FETCH-LOGICAL-c442t-c5b954e1ea0ead02fc8008551b6a7ef16358c357295aaaf5c15e253ad5ea29ef3</cites><orcidid>0000-0003-0902-3375</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30951766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-02395523$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Pages, Pierre-Jean</creatorcontrib><creatorcontrib>Boncoeur-Martel, Marie-Paule</creatorcontrib><creatorcontrib>Dalmay, François</creatorcontrib><creatorcontrib>Salle, Henri</creatorcontrib><creatorcontrib>Caire, François</creatorcontrib><creatorcontrib>Mounayer, Charbel</creatorcontrib><creatorcontrib>Rouchaud, Aymeric</creatorcontrib><title>Relevance of emergency head CT scan for fall in the elderly person</title><title>American journal of neuroradiology : AJNR</title><addtitle>J Neuroradiol</addtitle><description>Fall of the elderly person is a public health problem. The objectives of our study were to evaluate the relevance of systematically performing in emergency a computed tomography (CT) scan for fall in the elderly person, to identify specific criteria predicting the appearance of lesions. We performed a retrospective analysis of 500 consecutive patients aged 65 and over, who underwent an emergency head CT scan for fall from their height. Outcome at the end of the acute care, clinico-biological data and delays between trauma an d CT were collected, and crossed with a detection of head lesion on the CT scan. Of 500 patients, 38 (7.6%) had traumatic lesions depicted on the CT scan and 267 (53.4%) were hospitalized after the CT scan. Three (0.6%) had been operated for urgent head surgery. Nine of the 38 (23.6%) patients with traumatic lesion returned home. Presence of a lesion depicted on the CT scan was not correlated with the orientation of the patient (P &lt; 0.0001). Post-traumatic injury was significantly associated with male sex (RR = 2.19, P = 0.0217), consciousness impairment (RR = 1.56, P &lt; 0.0001), focal neurological deficit (RR = 6.36, P = 0.0362) and past history of post-traumatic brain injury (RR = 7.17, P = 0.0027). Anticoagulant therapy was not associated with increased risk of traumatic lesions (P = 0.3315). ROC analysis determined that a 5-hours time-interval between head trauma and CT allowed optimal detection of lesions. The systematic indication of an emergency head CT scan for fall in elderly patients presents a low diagnostic and therapeutic yield and is not relevant. Male sex, consciousness impairment, focal neurological deficit, past history of post-traumatic brain injury and time-interval between head trauma and CT are statistically related to the presence of lesions and should therefore be taken into account.</description><subject>Emergency</subject><subject>Geriatric</subject><subject>Life Sciences</subject><subject>Neurons and Cognition</subject><subject>Relevance</subject><subject>Traumatic brain injury</subject><subject>X-ray computed tomography</subject><issn>0150-9861</issn><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kMFKAzEQhoMotlbfQCRHPew6STbp5iLUolYoCFLBW0izs3bLdrcmbaFvb8pqj54GZr7_H_gIuWaQMmDqfpk2uPW2SDkwnYJIAbIT0mdaqERL_XlK-sAkJDpXrEcuQlgCcMYyfk56ArRkQ6X65PEda9zZxiFtS4or9F_YuD1doC3oeEaDsw0tW09LW9e0auhmgRTrAn29p2v0oW0uyVk8Brz6nQPy8fw0G0-S6dvL63g0TVyW8U3i5FzLDBlaiN3AS5cD5FKyubJDLJkSMndCDrmW1tpSOiaRS2ELiZZrLMWA3HW9C1ubta9W1u9NayszGU3NYQdcaCm52LHI3nbs2rffWwwbs6qCw7q2DbbbYDiHTGmRKx7RrEOdb0PwWB67GZiDabM0nWlzMG1AmGg6xm5-P2znKyyOoT-1EXjoAIxOdhV6E1wV3WJReXQbU7TV_x9-AHKtj04</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Pages, Pierre-Jean</creator><creator>Boncoeur-Martel, Marie-Paule</creator><creator>Dalmay, François</creator><creator>Salle, Henri</creator><creator>Caire, François</creator><creator>Mounayer, Charbel</creator><creator>Rouchaud, Aymeric</creator><general>Elsevier Masson SAS</general><general>American Society of Neuroradiology</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0003-0902-3375</orcidid></search><sort><creationdate>20200201</creationdate><title>Relevance of emergency head CT scan for fall in the elderly person</title><author>Pages, Pierre-Jean ; Boncoeur-Martel, Marie-Paule ; Dalmay, François ; Salle, Henri ; Caire, François ; Mounayer, Charbel ; Rouchaud, Aymeric</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-c5b954e1ea0ead02fc8008551b6a7ef16358c357295aaaf5c15e253ad5ea29ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Emergency</topic><topic>Geriatric</topic><topic>Life Sciences</topic><topic>Neurons and Cognition</topic><topic>Relevance</topic><topic>Traumatic brain injury</topic><topic>X-ray computed tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pages, Pierre-Jean</creatorcontrib><creatorcontrib>Boncoeur-Martel, Marie-Paule</creatorcontrib><creatorcontrib>Dalmay, François</creatorcontrib><creatorcontrib>Salle, Henri</creatorcontrib><creatorcontrib>Caire, François</creatorcontrib><creatorcontrib>Mounayer, Charbel</creatorcontrib><creatorcontrib>Rouchaud, Aymeric</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>American journal of neuroradiology : AJNR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pages, Pierre-Jean</au><au>Boncoeur-Martel, Marie-Paule</au><au>Dalmay, François</au><au>Salle, Henri</au><au>Caire, François</au><au>Mounayer, Charbel</au><au>Rouchaud, Aymeric</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relevance of emergency head CT scan for fall in the elderly person</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>J Neuroradiol</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>47</volume><issue>1</issue><spage>54</spage><epage>58</epage><pages>54-58</pages><issn>0150-9861</issn><issn>0195-6108</issn><eissn>1936-959X</eissn><abstract>Fall of the elderly person is a public health problem. The objectives of our study were to evaluate the relevance of systematically performing in emergency a computed tomography (CT) scan for fall in the elderly person, to identify specific criteria predicting the appearance of lesions. We performed a retrospective analysis of 500 consecutive patients aged 65 and over, who underwent an emergency head CT scan for fall from their height. Outcome at the end of the acute care, clinico-biological data and delays between trauma an d CT were collected, and crossed with a detection of head lesion on the CT scan. Of 500 patients, 38 (7.6%) had traumatic lesions depicted on the CT scan and 267 (53.4%) were hospitalized after the CT scan. Three (0.6%) had been operated for urgent head surgery. Nine of the 38 (23.6%) patients with traumatic lesion returned home. Presence of a lesion depicted on the CT scan was not correlated with the orientation of the patient (P &lt; 0.0001). Post-traumatic injury was significantly associated with male sex (RR = 2.19, P = 0.0217), consciousness impairment (RR = 1.56, P &lt; 0.0001), focal neurological deficit (RR = 6.36, P = 0.0362) and past history of post-traumatic brain injury (RR = 7.17, P = 0.0027). Anticoagulant therapy was not associated with increased risk of traumatic lesions (P = 0.3315). ROC analysis determined that a 5-hours time-interval between head trauma and CT allowed optimal detection of lesions. The systematic indication of an emergency head CT scan for fall in elderly patients presents a low diagnostic and therapeutic yield and is not relevant. Male sex, consciousness impairment, focal neurological deficit, past history of post-traumatic brain injury and time-interval between head trauma and CT are statistically related to the presence of lesions and should therefore be taken into account.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>30951766</pmid><doi>10.1016/j.neurad.2019.03.004</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-0902-3375</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0150-9861
ispartof American journal of neuroradiology : AJNR, 2020-02, Vol.47 (1), p.54-58
issn 0150-9861
0195-6108
1936-959X
language eng
recordid cdi_hal_primary_oai_HAL_hal_02395523v1
source Open Access: PubMed Central; Elsevier
subjects Emergency
Geriatric
Life Sciences
Neurons and Cognition
Relevance
Traumatic brain injury
X-ray computed tomography
title Relevance of emergency head CT scan for fall in the elderly person
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-29T20%3A19%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Relevance%20of%20emergency%20head%20CT%20scan%20for%20fall%20in%20the%20elderly%20person&rft.jtitle=American%20journal%20of%20neuroradiology%20:%20AJNR&rft.au=Pages,%20Pierre-Jean&rft.date=2020-02-01&rft.volume=47&rft.issue=1&rft.spage=54&rft.epage=58&rft.pages=54-58&rft.issn=0150-9861&rft.eissn=1936-959X&rft_id=info:doi/10.1016/j.neurad.2019.03.004&rft_dat=%3Cproquest_hal_p%3E2204693862%3C/proquest_hal_p%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c442t-c5b954e1ea0ead02fc8008551b6a7ef16358c357295aaaf5c15e253ad5ea29ef3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2204693862&rft_id=info:pmid/30951766&rfr_iscdi=true