Niedermeier Sandra, Wania Rebecca, Lampart Alina, Stahl Robert, Trumm Christoph, Kammerlander Christian, Böcker Wolfgang, Nickel Christian H, Bingisser Roland, Armbruster Marco, Pedersen Vera
Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany.
Department of Medicine, Kantonsspital Lucerne, Spitalstrasse, 6000 Lucerne, Switzerland.
Diagnostics (Basel). 2022 Jan 30;12(2):354. doi: 10.3390/diagnostics12020354.
Computed tomography (CT) is commonly used in trauma care, with increasing implementation during the emergency work-up of elderly patients with low-energy falls (LEF). The prevalence of incidental findings (IFs) resulting from CT imaging and requiring down-stream actions in this patient cohort is unknown. We have investigated the prevalence and urgency of IFs from emergency CT examinations in these patients.
A total of 2871 patients with LEF and emergency CT examinations were consecutively included in this retrospective cohort study. The primary endpoint was the prevalence of IFs; the secondary endpoint was their urgency.
The median age was 82 years (64.2% were women). IFs were identified in 73.9% of patients, with an average of 1.6 IFs per patient. Of all IFs, 16.4% were classified as urgent or relevant, predominantly in the abdomen, chest and neck. Increasing age was associated with the prevalence of an IF (odds ratio: 1.053, 95% confidence interval: 1.042-1.064). Significantly more IFs were found in female patients (75.2% vs. 71.5%).
IFs resulting from CT examinations of the elderly are frequent, but in more than 8 out of 10, they are harmless or currently asymptomatic. For the benefit of an accurate diagnosis of traumatic lesions, concerns about IFs with respect to disease burden, further work-up and resource utilisation might be disregarded.
计算机断层扫描（CT）常用于创伤护理，在对低能量跌倒（LEF）的老年患者进行急诊检查时的应用越来越多。在这一患者群体中，CT成像产生的偶然发现（IFs）以及需要后续处理的情况的发生率尚不清楚。我们调查了这些患者急诊CT检查中IFs的发生率和紧急程度。
本回顾性队列研究连续纳入了2871例LEF且接受急诊CT检查的患者。主要终点是IFs的发生率；次要终点是其紧急程度。
中位年龄为82岁（64.2%为女性）。73.9%的患者发现有IFs，每位患者平均有1.6个IFs。在所有IFs中，16.4%被归类为紧急或相关，主要在腹部、胸部和颈部。年龄增长与IFs的发生率相关（比值比：1.053，95%置信区间：1.042 - 1.064）。女性患者中发现的IFs明显更多（75.2%对71.5%）。
老年患者CT检查产生的IFs很常见，但十分之八以上是无害的或目前无症状的。为了准确诊断创伤性病变，对于IFs在疾病负担、进一步检查和资源利用方面的担忧可能可以忽略不计。
