Risk associated with traumatic intracranial bleed and outcome in patients following a fall from a standing position

Background: A fall from a standing position (FFS) is a low impact injury; however, in certain patient populations it can result in serious, complex injuries associated with significant morbidity and mortality. Objectives: The purpose of the study was to identify the patient population, risk factors and outcomes of intracranial bleed (ICB) after a fall from a standing position. Methods: Data of all patients from the trauma database at State designated Trauma Center were analyzed who FFS. Patient’s demography, clinical information was obtained. An ICB seen on computed tomography (CT) scan was considered positive. Results: From January 2001 through December 2008, 163 patients admitted to the trauma center after FFS. Ninety-one out of 163 patients (56 %) had positive CT scan. There was no significant difference between the groups with a positive or negative CT regarding age (P = 0.07), gender (P = 0.58), race (P = 0.15), Glasgow Coma Scale (P = 0.27), aspirin use (P = 0.06), Plavix (P = 0.92), combination of aspirin and Plavix (P = 0.86) or use of Coumadin (P = 0.82). Patients with ICB had significantly higher injury severity score (ISS) than patients without ICB (P < 0.0001). However, the overall mortality between the groups was not significant (P = 0.66). From a multiple logistic regression model, age ≥70 years was the only predictor for the ICB. Conclusion: A high proportion of our patients had positive ICB due to falls from a standing position. No significant differences were seen between the groups in terms of mortality. Age ≥70 years was the only factor for positive ICB. Level of evidence: Prognostic study investigating the effect of a patient characteristic on the outcome of the disease, level III.