@article{ref1,
title="Elder patients with closed head trauma: a comparison with nonelder patients",
journal="Academic emergency medicine",
year="1998",
author="Thomas, Stephen H. and Borczuk, P. and Nagurney, J. T.",
volume="5",
number="7",
pages="678-684",
abstract="OBJECTIVE: Little is known about the circumstances surrounding closed head trauma (CHT) in elders, and how they differ from nonelders. The study objective was to compare the 2 populations for outcome (positive cranial CT scan depicting traumatic injury, or the need for neurosurgery), mechanism of injury, and the value of the neurologic examination to predict a CT scan positive for traumatic injury or the need for neurosurgical intervention. METHODS: A retrospective study was conducted by collecting a case series of patients with blunt head trauma who underwent CT scanning, and comparing elder (aged > or =60 years) with nonelder patients. The setting was the ED of a university-affiliated Level-1 trauma center. RESULTS: Twenty percent of the elders and 13% of the nonelders had CT scans positive for traumatic injury, which conferred a risk ratio of 1.58 (95% CI 1.21-2.05). Older women were more at risk for the need for neurosurgery than were younger ones (3.1 vs 0.3%, RR 10.66, 95% CI 1.26-90.46). Among the elders, falls were the dominant mechanism of closed head trauma, followed by motor vehicle collisions (MVCs), then being struck as a pedestrian. In the nonelders, MVCs, falls, and assaults were the most important mechanisms of injury. A focally abnormal neurologic examination imparted an increased risk for both a CT scan positive for traumatic injury (elder 4.39, 95% CI 2.91-6.62; nonelder 7.75, 95% CI 5.53-10.72) and the need for neurosurgery (elder 35.68, 95% CI 4.58-275.89; nonelder 142.58, 95% CI 19.11-1064.22) in both age groups. CONCLUSIONS: Significant differences exist between elder and nonelder victims of CHT with respect to mechanisms of trauma and outcomes (CT scan positive for traumatic injury, or the need for neurosurgery).<p /><p>Language: en</p>",
language="en",
issn="1069-6563",
doi="",
url="http://dx.doi.org/"
}