Principal Investigator: Dr Kerstin de Wit, MBChB, BSc, MSc, MD, Hamilton Health Sciences, Assistant Professor, Department of Medicine, McMaster University

Local Investigator: Éric Mercier, emergency physician, trauma team leader and clinical researcher at the Centre de Recherche du CHU de Québec-Université Laval

Co-Investigators: Shoamanesh, A; Stiell, IG; Émond, M; Mc Leod SL

Local research coordinator: Sandrine Hegg
Local research nurse: Suzy Lavoie
Local research assistant: Mélina Vachon, Claire D’Assise

Granting agency: Canadian Institutes of Health Research – CIHR


Falls are the leading cause of traumatic death in the elderly with head injury causing half of these deaths. Each year, one in three adults over the age of 65 (seniors) fall, and half of these seniors seek treatment at a hospital emergency department (ED). There is a major evidence gap in the study of brain injury diagnosis in seniors, which is problematic for emergency physicians since the number of fall-associated head injuries is rising. ED diagnostic tools for risk stratification of these patients do not exist.

This study will derive a novel ED clinical decision rule for detecting traumatic intracranial bleeding which will standardize the approach to head CT scans. Once validated, we will optimize patient care by ensuring that intracranial bleeding is identified early. By reducing the use of head CT, this decision rule will lead to health care savings and streamlined, patient-centered ED care

Goals and objectives of this study

Our aim is to derive a clinical decision rule which will identify senior patients who present to the ED after a fall who are not at risk of intracranial bleeding, and do not require a head CT scan. This rule will be a highly sensitive and will also reduce the number of head CT scans.