{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:16:28Z","timestamp":1788477388265,"version":"build-2803163510"},"reference-count":40,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T00:00:00Z","timestamp":1577664000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Plain radiography (XR) series are standard of care for detection of fall-related fractures in older patients with low-energy falls (LEF) in the emergency department (ED). We have investigated the prevalence of fractures and diagnostic accuracy of XR imaging in the ED. Methods: 2839 patients with LEF, who were presented to two urban level I trauma centers in 2016 and received XR and computed tomography (CT), were consecutively included in this retrospective cohort study. The primary endpoint was the prevalence of fractures of the vertebral column, rib cage, pelvic ring, and proximal long bones. Secondary endpoints were diagnostic accuracy of XR for fracture detection with CT as reference standard and cumulative radiation doses applied. Results: Median age was 82 years (range 65\u2013105) with 64.1% female patients. Results revealed that 585\/2839 (20.6%) patients sustained fractures and 452\/2839 (15.9%) patients received subsequent XR and CT examinations of single body regions. Cross-tabulation analysis revealed sensitivity of XR of 49.7%, a positive likelihood ratio of 27.6, and negative likelihood ratio of 0.5. Conclusions: XR is of moderate diagnostic accuracy for ruling-out fractures of the spine, pelvic ring, and rib cage in older patients with LEF. Prospective validations are required to investigate the overall risk\u2013benefit of direct CT imaging strategies, considering the trade-off between diagnostic safety, health care costs, and radiation exposure.<\/jats:p>","DOI":"10.3390\/jcm9010097","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T03:28:53Z","timestamp":1578022133000},"page":"97","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Prevalence of Fractures and Diagnostic Accuracy of Emergency X-ray in Older Adults Sustaining a Low-Energy Fall: A Retrospective Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Alina","family":"Lampart","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"M\u00e4der","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Niedermeier","sequence":"additional","affiliation":[{"name":"Department for General, Trauma and Reconstructive Surgery, Ludwig Maximilian University Munich, Marchioninstr. 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Escher","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Stahl","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Neuroradiology, Ludwig Maximilian University Munich, Marchioninstr. 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1249-3338","authenticated-orcid":false,"given":"Christoph","family":"Trumm","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Neuroradiology, Ludwig Maximilian University Munich, Marchioninstr. 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kammerlander","sequence":"additional","affiliation":[{"name":"Department for General, Trauma and Reconstructive Surgery, Ludwig Maximilian University Munich, Marchioninstr. 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"B\u00f6cker","sequence":"additional","affiliation":[{"name":"Department for General, Trauma and Reconstructive Surgery, Ludwig Maximilian University Munich, Marchioninstr. 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian H.","family":"Nickel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Bingisser","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0542-5684","authenticated-orcid":false,"given":"Vera","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department for General, Trauma and Reconstructive Surgery, Ludwig Maximilian University Munich, Marchioninstr. 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.cger.2018.04.002","article-title":"Older adult falls in emergency medicine-A sentinel event","volume":"34","author":"Carpenter","year":"2018","journal-title":"Clin. 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