Incidental CT Findings in the Elderly with Low-Energy Falls: Prevalence and Implications - Niedermeier, S.; Wania, R.; Lampart, A.; Stahl, R.; Trumm, C.; Kammerlander, C.; Bocker, W.; Nickel, C. H.; Bingisser, R.; Armbruster, M.; Pedersen, V. (Diagnostics (Basel), 2022)
BACKGROUND: 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. METHODS: 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. RESULTS: 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%). CONCLUSION: 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.
Keywords: journalArticle; computed tomography; emergency imaging; incidental findings; low-energy fall; older adult