Blunt Head Injury in the Elderly: Analysis of the NEXUS II Injury Cohort
Authors: William R Mower, Thomas E Akie, Naseem Morizadeh, Malkeet Gupta, Gregory W Hendey, Jake L Wilson, Lorenzo Pierre Leonid Duvergne, Phillip Ma, Pravin Krishna, Robert M Rodriguez
Published in: Annals of Emergency Medicine, 2024 February 10
Conclusions:
- Elderly patients with blunt head injuries face a high risk of serious intracranial injuries even from low-risk injury mechanisms, such as ground-level falls.
- Clinical evaluations often fail to detect significant injuries in this group.
- The outcomes, especially after surgical intervention, frequently involve long-term disability or death.
Methods:
- Secondary analysis of patients aged 65 or older from the National Emergency X-Radiography Utilization Study (NEXUS) Head Computed Tomography validation study.
- Examination included demographics, injury mechanisms and presentations, injury types, interventions, and outcomes.
Results:
- Out of 11,770 patients in the NEXUS study, 3,659 were aged 65 or older.
- Significant injuries were found in 8.9% of these older patients, compared to 5.4% in younger counterparts.
- Older females represented 51.9% of the older patient group.
- Occult presentations occurred in 14.8% of older patients with significant injuries.
- Frequent injuries included subdural hematomas and subarachnoid hemorrhages.
- Ground-level falls were the most common injury mechanism, yet falls from ladders and automobile versus pedestrian accidents had the highest mortality rates.
- Among those requiring neurosurgical interventions, a low percentage returned home, many required extended care, and a high mortality rate was observed.