More than 3 million adults age 65 and older are treated in emergency rooms each year for injuries from falls. Head trauma is the most common source of significant injury, with skull fractures having serious consequences. According to the 2016 National Trauma Database Annual Report, women account for 58 percent of all falls. Because geriatric women have an increased rate of falls and facial fractures, determining whether they are also at increased risk of skull fractures is important. Currently, research on the prevalence of skull fractures due to head injury in this population is sparse.
Furthermore, there is an overall lack of research regarding guidelines for the management of head injury among the geriatric population. Researchers from Florida Atlantic University’s Schmidt College of Medicine conducted a study to assess and compare skull fracture risk in female and male patients age 65 and older.
They prospectively evaluated all patients with head trauma at two level-one trauma centers in southeast Florida serving a population of more than 360,000 geriatric patients. For the study, researchers examined skull fractures caused by acute trauma and compared them by gender as well as patient’s race/ethnicity and mechanism of injury. Of the 5,402 patients enrolled, 56 percent were female, and 44 percent were male.
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Seventy-five percent of head injuries were due to falls, and this trend was also observed across race/ethnicity and mechanism of injury. The mean age of both females and males was 82.8 and 81.1 years, respectively. The results of the study, published in the American Journal of Emergency Medicine, showed that when comparing geriatric men and women, men had a significantly increased incidence of skull fractures due to head trauma, mostly due to falls.
This result was unexpected, as previous research has indicated that women are more susceptible to facial fractures. This trend was also seen across race/ethnicity, although the results were statistically significant only for whites. Scott M. Alter, MD, first author, associate professor of emergency medicine and assistant dean, said, “The high incidence of head injuries and subsequent skull fractures due to falls is a cause for concern as our aging population leads an active lifestyle.” is living.” Clinical Research, FAU Schmidt College of Medicine.
“Since falls account for the largest number of head injuries and subsequent skull fractures, fall prevention may be an important intervention to consider to reduce morbidity. While can be addressed in living facilities, the emergency department can also represent an opportunity to educate patients and prevent future death and disability from falls in this population.”