Falls are the most common cause of injury among adults 65 and older in the United States. According to the U.S.
Centers for Disease Control and Prevention, every year, more than 14 million older adults (one in four) report a fall. About 90% of head injuries among older individuals is due to ground-level falls. Evaluating an older adult with a head injury in the emergency department (ED) requires careful assessment due to the increased risk of complications such as intracranial hemorrhage.
There also is heightened concern for older patients taking anticoagulants or blood thinners who sustain a head injury because of the risk of delayed intracranial hemorrhage (ICH). ICH is a type of traumatic intracranial hemorrhage that takes place in various areas of the brain. A delayed ICH can occur up to several weeks after the injury, but usually within 48 hours.
As such, this risk has prompted some providers to admit these patients to the hospital for observation and repeat CT scans, the imaging modality of choice for evaluating acute head injuries. Previous reports have suggested rates as high as 7.2% for delayed ICH in older adults on anticoagulants who sustain a head injury, sparking debate over management practices.
Currently, the need for observation and routine follow-up diagnostic CT scans remains controversial. Now, a new study by researchers at Florida Atlantic University's Schmidt College of Medicine challenges previous higher estimates of delayed ICH incidence in this patient.
