Risk of Traumatic Intracranial Hemorrhage From Low-Energy Falls in the Oldest-Old Patients

Abstract

Background: The population of individuals classified as oldest-old (aged ≥85 years) has increased rapidly in recent years. The rates of morbidity from chronic diseases and physical dependence tend to be higher in the oldest-old compared with individuals classified as young-to-middle-old (aged 65-84 years). Therefore, the classification and evaluation of traumatic injuries in the oldest-old group are necessary. Herein we focused on the risk of traumatic intracranial hemorrhage from low-energy falls in older patients. Methods: Patient medical records from the Emergency Department after low-energy falls that occurred between November 2014 and April 2016 were retrospectively analyzed. Patients were divided into an older group (aged ≥65 years) and an adult group (aged 18-64 years); the older group was subdivided into the oldest-old group (aged ≥85 years) and a young-to-middle-old group (aged 65-84 years). The rate of intracranial hemorrhage and related factors were also investigated. Results: The older group had a greater risk of traumatic intracranial hemorrhage than the adult group (20% vs. 12.6%, p=0.019). Furthermore, more cases of traumatic intracranial hemorrhage were found in the oldest-old group than in the young-to-middle-old group (37.5% vs. 18.0%, p=0.024). Similarly, the risk of traumatic intracranial hemorrhage in the oldest-old was higher than in the young-to-middle-old group (p=0.032). Conclusion: The risk of traumatic intracranial hemorrhage from low-energy falls in the oldest-old patients was higher than in the young-to-middle-old patients. Therefore, physicians need to pay particular attention to oldest-old patients, even to those with mental integrity and without neurological deficits.

Keywords

• Oldest old
• Accidental falls
• Intracranial hemorrhage
• Emergency