TY - JOUR PY - 2013// TI - Minor head injury in the elderly at very low risk: a retrospective study of 6 years in an emergency department JO - American journal of emergency medicine A1 - Riccardi, Alessandro A1 - Frumento, Flavio A1 - Guiddo, Grazia A1 - Spinola, Maria Beatrice A1 - Corti, Luca A1 - Minuto, Pierangela A1 - Lerza, Roberto SP - 37 EP - 41 VL - 31 IS - 1 N2 - INTRODUCTION: Mild head injury (MHI) is a common clinical problem in emergency departments (EDs). Long-standing debate is still going on about MHI in the elderly: current guidelines recommend to perform a CT scan on this group. MATERIALS AND METHODS: We performed a retrospective study by reviewing patients older than 65 years, evaluated in our ED for which a CT scan of the head was performed for MHI, between 2004 and 2010. According to Italian Guidelines, we considered only patients with low-risk MHI. RESULTS: We considered 2149 eligible patients: we recorded 47 pathological acute findings on CT scan (2.18%), but only 3 patients (0.14%) underwent neurosurgery. We analysed our patients according to different age groups: in patients in the 65- to 79-year-old group, we documented pathological findings on CT in 0.66% of cases, with a significant increase in the group older than 80 years, with a rate of 3.33% of acute findings on CT (OR 5.22, P < .001); 617 patients were on antiplatelet therapy: 22 of these patients (3.72%) had a pathological finding on CT scan (OR 2.23, P < .005). DISCUSSION: Our retrospective analyses demonstrated that the incidence of intracranial complications after MHI is not different from that of the general population, and based on this finding, a CT does not seem to be necessary, at least up to 80 years old. Our data suggest that antiplatelet therapy could be a significant risk factor. Our results suggest that elderly patients between 65 and 79 years old without risk factors could be managed as younger patients.

Language: en

LA - en SN - 0735-6757 UR - http://dx.doi.org/10.1016/j.ajem.2012.05.023 ID - ref1 ER -