Elderly XXXX with closed @entity542 after a fall: mechanisms and outcomes.

@entity1 @entity131 @entity3439 @entity341 @entity542 @entity130
Falls in the elderly leading to closed @entity542 represent a significant cause of morbidity and mortality in that population, but are not well-characterized. The purpose of this study was to determine the mechanism of fall, outcome, and additional risk factors in elderly @entity1 who require cranial computed tomography (CT) scan after a fall. We conducted a retrospective case series of @entity1 age 60 years and older with closed @entity542 secondary to falling who underwent CT scan in the @entity341 ( @entity341 ). Data were gathered from @entity341 and hospital records. The setting was an urban Level I @entity130 center. Our series consisted of 189 @entity1 , of whom 31 (16%) had an abnormal head CT scan and four (2%) required neurosurgery. @entity131 (38%) and @entity3439 (33%) were the most common lesions seen on CT scan. Falls from standing (76%) were more common than falls on stairs (19%) or from height (5%), but the latter two were more likely to result in an abnormal CT scan (stairs 42%, height 40%). An abnormal neurologic examination was associated with a higher risk of the need for neurosurgery (risk ratio 11.5). We conclude that among elderly @entity1 who fall and present to an @entity341 with evidence of closed @entity542 , a significant percentage will have abnormal CT scans but only a small minority will require neurosurgery. While falls from standing are more common, falls on stairs or from height are associated with a higher risk of having an abnormal CT scan. A focal neurologic examination is a strong predictor of the need for neurosurgical intervention.
