Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnosis of falls
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – to rule out arrhythmia, conduction disorder, or myocardial infarction (heart attack)
- Computed tomography of the skull (cranial CT, cranial CT or cCT) – if a neurological cause is suspected (eg, apoplexy (stroke)), tumors).
- Electrical impedance analysis (measurement of body compartments / body composition) – to determine body fat, extracellular body mass (blood and tissue fluid), body cell mass (muscle and organ mass) and total body water including body mass index (BMI, body mass index) and waist-to-hip ratio (THV); e.g. due tosuspicion of malnutrition (malnutrition).
- Long-term blood pressure measurement (24-hour blood pressure measurement) – to exclude disorders of blood pressure regulation.
- Implanted event recorder (implanted small device with memory chip that can record occasional cardiac arrhythmias) [cardiac arrhythmias?] – to elucidate causes of falls.
Further notes
- Elderly patients (> 55 years of age) should undergo cranial CT after a fall even if they are hemodynamically stable and their GCS score (Glasgow Coma Score; assessment scheme for disorders of consciousness and brain function after traumatic brain injury) is normal. One in three patients studied in this way showed a positive CT finding, after which the therapeutic approach had to be changed in 95 cases (21.7% of patients) (4.3% underwent neurosurgery; 17% received modified medication due to CT findings).CONCLUSION: The study confirms that older age is a risk factor for a positive CT finding of the skull and necessary neurosurgical intervention.
