What question did this study set out to answer?

Evaluate the necessity of head CT scans in elderly patients after ground-level falls without direct head injury.

April 20, 2026Open Access

The Value of Non-Contrast Computed Tomography in the Elderly After Ground Level Falls When Direct Head Injury is Absent or Uncertain – a Retrospective Cohort

Key Points

Evaluate the necessity of head CT scans in elderly patients after ground-level falls without direct head injury.
Retrospective cohort study of patients aged 65 or older with absent or uncertain direct head injury.
Patients evaluated for intracranial hemorrhage and associated outcomes such as neurosurgical intervention, disposition, and mortality.
Data collected included cognitive status, Glasgow Coma Scale, and comorbidity indices.
Intracranial hemorrhage rates were low at 2.8% across all patients.
Neurosurgical intervention rates were also low, at 0.8%.
CTAS scores indicated higher odds of ICH in patients scoring 1-2 compared to 3-5.

Abstract

Elderly patients after ground-level falls (GLFs) often present to the emergency department (ED) without evidence of direct head injury (EDHI) and pose a dilemma if a head computed tomography (CT) is warranted. Intracranial hemorrhage (ICH) is possible even without EDHI ascribable to challenging history and physical examination (H however, neither were significant in logistic regression. Due to the low ICH rate, and an even lower neurosurgical intervention rate, routine head CT for elderly GLFs without EDHI demands prudence. Questionable causality between GLFs and ICH and high rate of potential false-positive strengthen this claim. Considerations are recommended according to case specifics and risk-factors presented here and in the limited literature.

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Cite This Study

Fischer et al. (Wed,) studied this question.

synapsesocial.com/papers/69e5c2d003c2939914028cda https://doi.org/https://doi.org/10.1016/j.nexres.2026.101765

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