Abstract
Purpose
To determine the rate of clinically impactful body injury among patients who had a fall from standing height with an associated head/neck injury, but without evidence of body injury on physical exam or plain radiographs. We also examine surgical/endovascular intervention related to body injury and mortality rates for head/neck and body injury.
Methods
Retrospective study of 288 patients with CT evidence of acute head/neck injury that underwent body CT despite the absence of clinical or radiographic evidence of body injury. Predictor variables were age, sex, race/ethnicity, and body mass index (BMI).
Results
There were 11.5% (n = 33) with body injury on CT (n = 33). There were 3.1% (n = 9) with clinically impactful body injury. No patient had either surgical/endovascular intervention or mortality related to body injury. Additionally, 8.7% (n = 25) had mortality from head/neck injury. Increased age (OR = 1.05, 95% CI: 1.01, 1.08, p = 0.01) and overweight BMI (25–29.99 kg/m2) (OR = 2.85, 95% CI: 1.07, 7.62, p = 0.04) were each significantly associated with increased odds for mortality from head/neck injury.
Conclusion
Patients with falls from standing height and known head/neck injury had a low rate of clinically impactful body injury. None of the studied variables were associated with increased risk of body injury in this patient population. The low rate of clinically impactful body injury and the lack of any mortality, procedure, or transfusion resulting from body injury suggest that body CT may not be necessary in patients with head/neck injury in the absence of clinical or radiographic evidence of body injury.
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Data availability
Data will be made available upon request.
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All authors contributed to the study conception and design. Data collection was performed by Asad Baig and Fiza Khan. Data analysis was performed by Joshua Fogel. A draft of the manuscript was written by Asad Baig and Michael J. Drabkin. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This retrospective study was IRB approved. The need for informed consent was waived. This study was performed in accordance with the Declaration of Helsinki.
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Baig, A., Drabkin, M.J., Khan, F. et al. Patients with falls from standing height and head or neck injury may not require body CT in the absence of signs or symptoms of body injury. Emerg Radiol 28, 239–243 (2021). https://doi.org/10.1007/s10140-020-01843-9
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DOI: https://doi.org/10.1007/s10140-020-01843-9