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Journal article
A Clinical Audit of the Use of CT Head Scan Post-Inpatient Falls in Hospitalised Older Adults Utilising a Post-Fall Clinical Pathway
International Journal of Environmental Research and Public Health, Vol.22(7), pp.1-9
2025
Abstract
Background: Older adults are at high risk of falls, and head injuries following these events can have devastating consequences. The In-Patient Post Fall Clinical Pathway is a tool utilised in many hospitals in Queensland, Australia, to guide the need for CT brain imaging post-inpatient fall. This audit aimed to assess the use of CT imaging following inpatient falls in older adults, evaluate adherence to the In-Patient Post Fall Clinical Pathway, and explore factors associated with serious head injury. Methods: A retrospective audit was conducted across two regional Queensland hospitals over 2.5 years. Falls involving patients aged over 65 years were included. Data were analysed using descriptive and bivariate statistical tests. Results: Among 874 eligible falls, the mean patient age was 80.4 years, and approximately two-thirds were male. While 90.6% of patients who had fallen met clinical pathway criteria for a CT head scan, only 50.1% of them received a scan. Serious head injuries were uncommon (2.25% of total falls), with subdural haematoma being most frequent. Only one patient underwent neurosurgical intervention. No missed serious injuries were identified. No individual characteristic was significantly associated with serious head injury, although trends were observed for unwitnessed falls, falls from bed, falls with a head strike, new symptoms four hours post-fall, and anticoagulant use. Conclusions: There is a gap between clinical pathway recommendations and imaging practices, with clinicians often relying on judgement over strict adherence to guidelines. Further research is needed to inform evidence-based and practical decision-making to balance imaging use with clinical risk.
Details
- Title
- A Clinical Audit of the Use of CT Head Scan Post-Inpatient Falls in Hospitalised Older Adults Utilising a Post-Fall Clinical Pathway
- Authors
- Isabel Watt - Northern Adelaide Local Health Network (Australia)Ruth Devin - Sunshine Coast Health (Australia)Joyita Bhattacharya - Sunshine Coast Health (Australia)Frances Waldie - Sunshine Coast Health (Australia)Emma Holden - Sunshine Coast Health (Australia)Jo Wu (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health - Nursing
- Publication details
- International Journal of Environmental Research and Public Health, Vol.22(7), pp.1-9
- Publisher
- MDPI AG
- Date published
- 2025
- DOI
- 10.3390/ijerph22071098
- ISSN
- 1660-4601; 1661-7827
- Copyright note
- © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- Data Availability
- The original contributions presented in this study are included in the article.
- Organisation Unit
- Healthy Ageing Research Cluster; School of Health - Nursing
- Language
- English
- Record Identifier
- 991142640202621
- Output Type
- Journal article
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