S. Quintero-Argentin2, S. Ramirez-Pagan2, G. Cartagena-Santana2, Y. Barreto-Cruz2, F. Habib1 1Abrazo West Campus, Trauma, Goodyear, ARIZONA, USA 2Universidad Autonoma de Guadalajara School of Medicine, Zapopan, JALISCO, Mexico
Introduction: Utility of CT PanScans in elderly patients (age ≥ 65) sustaining Ground Level Falls (GLF) who present with a GCS of 15 has previously been questioned. Its value in patients on pre-injury anticoagulants (pAC) remains poorly defined. We hypothesized that PanScans in this group of patients would better identify those with more severe injuries and correlate with increased resource utilization, and worse outcomes.
Methods: A retrospective review of all elderly GLF seen at our suburban Level I trauma center were reviewed and patients who were GCS 15 at presentation and had undergone a PanScan for the study period of January 2021 to April 2022 were identified. Demographics, PanScan results, need for ICU admission, ICU LOS, hospital LOS, mortality and discharge disposition were abstracted from the medical records. Categorical variables were compared using the Fisher's exact test and continuous variables using the Student's t test. A p value of <0.05 was selected for statistical significance.
Results: Of 600 elderly GLF patients treated during the study period 128 (21.3%) had undergone PanScans at the clinicians discretion. Among these 68 (53.1%) were on pAC. ISS was similar in the two groups (7.72 ± 4.95 in those on pAC and 8.27 ± 4.47 in those not on pAC, p=0.52). Patients on pAC undergoing PanScans were not more likely to need ICU admission (16 of 68 vs. 11 of 60, p=0.24), but had a longer ICU LOS (3.27 ± 1.91 vs. 2.4 ± 0.89 days). Hospital LOS was no different between groups (5.0 ± 2.88 vs.5.0 ± 2.75 days, p=0.99). There were no in-hospital mortalities in either group. A non-home disposition occurred in a high proportion of patients but was not significantly different between the groups (60 of 68 vs. 57 of 60, p = 0.09).
Conclusion: In elderly patients presenting with a GCS of 15 following a ground level fall, despite similar injury severity scores, those on pre-injury anticoagulants had longer ICU lengths of stay. Evaluation of the basis of this finding in a prospective manner appears to be warranted.