The Utility of Pan-Scan Imaging in Older Patients After Ground-Level Falls: A Comparative Study.

BACKGROUND: This study assessed pan-scan versus selective CT (SCT) for ground-level falls in older adults. METHODS: This was a retrospective cohort study of adults aged 65+ who sustained a ground-level fall. Patients underwent SCT (brain, cervical spine, plus one additional CT scan) or pan-scan (brain, cervical/thoracic/lumbar spine, abdomen/pelvis, and chest). RESULTS: Two hundred three patients received SCT (n=105, 51.7%) or pan-scan (n=98, 48.3%). Significantly more consultations based on incidental findings were found in the pan-scan group (P=0.020). Significantly more operative interventions were seen among those who had a pan-scan (n=43, 43.9%) compared with those who had SCT (n=19, 18.1%; p<0.001). Patients who received SCT had a significantly shorter hospital course (average 4.0 days vs 6.0 days; p=0.001), without mortality difference (p=0.168). Multivariable linear regression models predicted that having a pan-scan increased hospital length of stay (R2=0.603). CONCLUSIONS: Use of a physical exam as a guide for diagnostic imaging reduces unnecessary imaging without compromising patient outcomes and may reduce hospital length of stay.