Abstract
Fall-related hospitalizations among older adults have been increasing in recent decades. One of the most common reasons for this is minimal or mild traumatic brain injury (mTBI) in older individuals taking anticoagulant medication. In this study, we analyzed all inpatient stays from January 2017 to December 2019 of patients aged > 75 years with a mTBI on anticoagulant therapy who received at least two cranial computer tomography (cCT) scans. Of 1477 inpatient stays, 39 had primary cranial bleeding, and in 1438 the results of initial scans were negative for cranial bleeding. Of these 1438 cases, 6 suffered secondary bleeding from the control cCT scan. There was no significance for bleeding related to the type of anticoagulation. We conclude that geriatric patients under anticoagulant medication don’t need a second cCT scan if the primary cCT was negative for intracranial bleeding and the patient shows no clinical signs of bleeding. These patients can be dismissed but require an evaluation for need of home care or protective measures to prevent recurrent falls. The type of anticoagulant medication does not affect the risk of bleeding.
Highlights
Older populations are growing continuously in high income countries (HIC) [1]
We evaluated the incidence of a delayed intracranial bleeding after primary negative cranial computer tomography (cCT) of older patients admitted to the hospital
When the cCT control scan was positive for intracranial bleeding, we evaluated the bleeding on the cCT control scans and the resulting hospital stay
Summary
Older populations are growing continuously in high income countries (HIC) [1]. In addition to the increasing number of comorbidities and medications, musculoskeletal decay has become relevant for this part among the population [2]. As a result of the aging process, these patients have difficulty performing daily tasks; a fall represents an early symptom of coping-failure [6]. These patients are likely to require care by family or nursing professionals sooner or later. Frequent reasons for hospital admission include fractures of the proximal femur, the spine, the proximal humerus, and the distal radius [9]. Besides these fractures, traumatic brain injury (TBI) caused by a fall is an increasing reason for hospitalization in older patients [10]. A fall is the main reason for a traumatic brain injury (51%), followed by car accidents (9%) [11]
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