For injuries incurred in falls, more than 3 million people 65 and older need emergency room treatment each year. Skull fractures are a major consequence of head trauma, which is the most frequent cause of serious damage. Women make up 58 per cent of all falls, according to the 2016 National Trauma Database annual report.
It is critical to determine if senior females are likewise at an elevated risk of skull fractures because they have a higher likelihood of falls and facial fractures. Research on the frequency of skull fractures due to head injury in this population is currently lacking. Also, there is a general paucity of information on best practices for managing head injuries in the older population.
Researchers from Florida Atlantic University’s Schmidt College of Medicine undertook a study to evaluate and compare the risk of skull fracture secondary to head trauma in female and male patients ages 65 and older. They prospectively evaluated all patients with head trauma at two level-one trauma centres in southeast Florida, serving a population of more than 360,000 geriatric patients.
For the study, researchers examined skull fracture due to acute trauma and compared them by sex as well as patient race/ethnicity and mechanism of injury. Among the 5,402 patients enrolled, 56 per cent were female, and 44 per cent were male. Eighty-five per cent of the head injuries sustained were due to falls, and this trend also was seen across race/ethnicity and mechanism of injury. Both females and males had a similar mean age, 82.8 and 81.1 years, respectively.
Results of the study, published in the American Journal of Emergency Medicine, showed that when comparing geriatric males and females, males had a significantly increased incidence of skull fracture secondary to head trauma, due mostly to falls. This outcome was unexpected, as previous research has indicated females are more susceptible to facial fractures. This trend also was seen across race/ethnicity, though results were only statistically significant for whites.
Scott M Alter, M D, first author, associate professor of emergency medicine and assistant dean for clinical research at FAU Schmidt College of Medicine, said, “The high incidence of head injury and subsequent skull fractures due to falls is a cause for concern as our aging population continues living active lifestyles”. “As falls caused the greatest number of head injuries and subsequent skull fractures, fall prevention may be an important intervention to consider in reducing morbidity. Although fall prevention education can be addressed in the primary care setting or at assisted living facilities, the emergency department could also represent an opportunity to educate patients and to prevent future death and disability from falls in this population.”
