PURPOSE: The purpose of the study was to identify the risk factors and outcomes of brain injury after fall from a standing position.
METHODS: Data of all patients were analyzed who fell from a standing position. Patient’s demography, clinical information was obtained. The computed tomography (CT) scan of the brain was obtained in all patients. Intracranial bleed on CT scan was considered positive. Data were summarized as means, standard deviation, median or percentage. The medians length of stay were estimated by using the Kaplan-Meier method and compared by using the log-rank test. Multiple logistic regression analysis was used to assess the association between the CT result and potential risk factors.
RESULTS: From January 2001 through December 2008, 163 patients admitted to the trauma center after fall from a standing position. Ninety-one out of 163 patients (56%) had positive CT scan of the intracranial bleeding. This group was compared with the patients with no intracranial bleeding. There was no significant difference between the groups regarding age (P=0.07), gender (P=0.48) race (P=0.17) Glasgow Coma Scale (P=0.27), plavix (P=0.90), combination of Aspirin and plavix (P=0.92) and use of coumadin (P=0.97). Patients with intracranial bleed had significantly higher proportion of Aspirin use (P=0.04), initial systolic blood pressure (P=0.04), injury severity score (P< 0.0001) compare to control group. However, the overall mortality between the groups was not statistically significant (P=0.50). Also the length of stay for the bleeding group was not significantly longer (median [95% confidence interval of median]: 5 [4, 7] vs. 3 [3, 5], P-0.24). From a multiple logistic regression model, after controlling for age, gender, race, SBP, heart rate, ISS was the only predictor for the intracranial bleeding (odds ratio: 1.14, 95% confidence interval: [1.08, 1.21]). Use of Aspirin were not significantly associated with intracranial bleeding in the same model.
CONCLUSION: A high proportion of our patients had positive intracranial bleeding due to fall from a standing position. ISS is a predictor for the positive intracranial bleed.
CLINICAL IMPLICATIONS: FFS requires Brain CT evaluation.
DISCLOSURE: Nasim Ahmed, No Financial Disclosure Information; No Product/Research Disclosure Information