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地面坠落伤:按年龄组划分的计算机断层扫描表现和临床转归。

Ground level falls: computed tomography findings and clinical outcomes by age groups.

机构信息

Department of Radiology, Ankara City Hospital, Ankara, Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2023 Jun;29(6):710-716. doi: 10.14744/tjtes.2023.28741.

Abstract

BACKGROUND

This study aimed to determine injury patterns in ground level falls (GLFs) and investigate the effect of age on the severity of injury.

METHODS

We retrospectively identified 4,712 patients who presented to a Level 1 trauma center due to GLFs and analyzed the data of 1,214 patients who underwent computed tomography (CT). Demographics, torso examination findings, and injuries detected on CT were recorded. To investigate the effect of age on injury severity, the patients were grouped as those aged <65 and ≥65 years.

RESULTS

The mean age was 57 years, and 55.20% of the patients were female. The mortality rate was 0.50%. Injury was detected in 489 (40.30%) patients on CT. Fractures were the most common injury type. Traumatic intracranial hemorrhage was detected in 32 (2.60%) patients. Only three (0.20%) of the 63 patients with rib fractures had concomitant lung injury. The negative predictive value of the physical examination (PE) was 95.80% for chest injury. Intra-abdominal injury was not detected in any of the 116 patients who underwent abdominal CT. Hospitalization was also higher in the ≥65-year group (p<0.001). All mortalities (n=6) were seen in patients aged ≥65 years.

CONCLUSION

Our results indicate that GLFs cause more injuries in the elderly, resulting in more hospitalizations and mortality. Normal PE findings may reduce the need for whole-body CT in GLF patients who are conscious, cooperative, and oriented.

摘要

背景

本研究旨在确定地面水平跌倒(GLF)中的损伤模式,并研究年龄对损伤严重程度的影响。

方法

我们回顾性地确定了 4712 名因 GLF 而到 1 级创伤中心就诊的患者,并对 1214 名接受计算机断层扫描(CT)的患者进行了数据分析。记录了患者的人口统计学资料、躯干检查结果以及 CT 上发现的损伤。为了研究年龄对损伤严重程度的影响,我们将患者分为年龄<65 岁和≥65 岁两组。

结果

患者的平均年龄为 57 岁,55.20%为女性。死亡率为 0.50%。489(40.30%)名患者在 CT 上发现损伤。骨折是最常见的损伤类型。32(2.60%)名患者有创伤性颅内出血。63 名肋骨骨折患者中只有 3 名(0.20%)合并肺部损伤。体格检查(PE)的阴性预测值对胸部损伤为 95.80%。116 名接受腹部 CT 的患者中均未发现腹部损伤。≥65 岁组的住院率也更高(p<0.001)。所有死亡患者(n=6)均为≥65 岁患者。

结论

我们的研究结果表明,GLF 会对老年人造成更多的伤害,导致更多的住院和死亡。对于意识清醒、配合良好且定向力正常的 GLF 患者,正常的 PE 检查结果可能减少全身 CT 的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6bf/10315935/de1d12a848c6/TJTES-29-710-g001.jpg

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