Study: Risk of skull fractures is higher in men than women

WASHINGTON: Every year, more than 3 million persons 65 and older need emergency room treatment for injuries sustained in falls. Skull fractures are a major consequence of head trauma, which is the most frequent cause of serious damage.

According to the 2016 National Trauma Database annual report, women make up 58 per cent of all falls. Determining if senior females are likewise at an elevated risk of skull fractures is critical because they have a higher likelihood of falls and facial fractures.

Research on the frequency of skull fracture due to head injury in this population is currently lacking. Also, there is a general paucity of information on best practises for managing head injuries in the older population.

Researchers from Florida Atlantic University's Schmidt College of Medicine conducted a study to assess 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 centers 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 percent were female, 44 percent were male. Eighty-five percent 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.

"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," said Scott M. Alter, M.D., first author, associate professor of emergence medicine, and assistant dean for clinical research, FAU Schmidt College of Medicine.

"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."