319: Icu Utilization in Elderly Tbi Patients After Ground-Level Falls: Single-Center Retrospective Review

Introduction: Ground-level falls (GLFs) have become the leading cause of traumatic brain injury (TBI) in older adults, surpassing motor vehicle collisions over the last decade. Elderly patients with TBI frequently require intensive care unit (ICU) admission and often need neurosurgical intervention, contributing significantly to critical care resource utilization. This study evaluates ICU use and clinical outcomes in elderly patients with TBI following GLFs. Methods: We conducted a retrospective review of all patients over age 60 who presented to a Level I trauma center in 2024 after a GLF. Data were extracted from the electronic health record using trauma-related codes and verified by manual chart review. Patients were stratified by age, injury characteristics, ICU admission status, neurosurgical procedures, and discharge disposition. Descriptive statistics were performed using Microsoft Excel. Results: Among 6,202 trauma activations in 2024, 1,288 (20.8%) were related to GLFs. Of these, 237 patients (18.4%) sustained a TBI. Age distribution of TBI patients was: 60–69 years (11.8%), 70–79 (25.7%), 80–89 (47.7%), and ≥90 (15.6%). ICU admission was required in 111 patients (46.8%). Among those admitted to the ICU, 34 (30.6%) underwent neurosurgical procedures, including 10 craniotomies/craniectomies, 4 burr hole evacuations, and 10 intracranial pressure monitor placements. The in-hospital mortality rate was 5.5%, while 55.7% were discharged home. Conclusions: GLF-related TBI in elderly patients presents a substantial burden on critical care systems. Nearly half of affected patients required ICU-level care, and a meaningful proportion required neurosurgical intervention. These data underscore the importance of early identification, multidisciplinary care coordination, and ICU resource planning for the aging trauma population. Preventive strategies and improved risk stratification tools are urgently needed as the incidence of GLF-related TBI continues to rise.