• Scott M Alter, Michelly R Gonzalez, Joshua J Solano, Lisa M Clayton, Patrick G Hughes, and Richard D Shih.
• Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, 777 Glades Road, BC-71, Boca Raton, FL 33431, USA; Department of Emergency Medicine, Delray Medical Center, 5352 Linton Blvd, Delray Beach, FL 33484, USA. Electronic address: alters@health.fau.edu.
• Am J Emerg Med. 2023 Mar 1; 65: 168171168-171.

BackgroundHead trauma is the leading cause of serious injury in the older adult population with skull fractures as a serious reported outcome. This study aims to evaluate the role of sex in the risk of skull fracture in patients over the age of 65.MethodsA prospective cohort study was conducted at two level-one trauma centers, serving a population of 360,000 geriatric residents. Over a year-long period, consecutive patients aged 65 years and older who presented with blunt head injury were included. Patients who did not receive head CT imaging were excluded. The primary outcome was rate of skull fracture due to the acute trauma, compared by sex. Additional factors examined included patient race/ethnicity and mechanism of injury.ResultsAmong 5402 patients enrolled, 3010 (56%) were female and 2392 (44%) were male. 4612 (85%) of the head injuries sustained were due to falls, and 4536 (90%) of all subjects were Caucasian. Overall, 199 patients (3.7%) sustained skull fractures. Males had a significantly greater rate of skull fracture when compared to females (4.6% vs 3.0%, OR 1.5, 95% CI: 1.2-2.1, p = 0.002). This trend was also seen across race/ethnicity and mechanism of injury.ConclusionsOlder males were found to have a higher rate of skull fractures compared to females after sustaining blunt head trauma, mostly due to falls.Copyright © 2023 Elsevier Inc. All rights reserved.

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