Low Incidence of Delayed Intracranial Hemorrhage in Geriatric Emergency Department Patients on Preinjury Anticoagulation Presenting with Blunt Head Trauma

Shih, Richard D.; Alter, Scott M.; Solano, Joshua J.; Engstrom, Gabriella; Wells, Mike; Clayton, Lisa M.; Hughes, Patrick G.; Goldstein, Lara Nicole; Azar, Faris K.; Ouslander, Joseph G.

doi:10.1016/j.jemermed.2024.06.002

Cited by 1 publication

(1 citation statement)

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“…Data from the Geriatric Head Trauma Short Term Outcomes Project (GREAT STOP) were used for the current study. 11 This study included a prospective cohort of consecutive patients presenting to the EDs of Delray Medical Center and Bethesda Hospital East, two level one, university‐affiliated trauma centers in Palm Beach County, Florida, USA. The EDs have annual volumes of 50,000 and 69,000 respectively.…”

Section: Methodsmentioning

confidence: 99%

Alcohol use is associated with intracranial hemorrhage in older emergency department head trauma patients

Zirulnik,

Liu,

Wells

et al. 2024

JACEP Open

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ObjectivesFalls are common in adults aged 65 years and older and are the leading cause of traumatic brain injuries in this age group. Alcohol use may increase the risk of falls as well as the severity of resultant injuries. The aim of this study was to examine the association between self‐reported alcohol use and the prevalence of intracranial hemorrhage (ICH) in this patient group.MethodsThis was a secondary analysis of the Geriatric Head Trauma Short Term Outcomes Project (GREAT STOP), a study of older adults with blunt head trauma from a fall. We determined the characteristics of every fall event, including patient demographics and medical history, and clinical signs and symptoms related to head trauma. Self‐reported alcohol use was categorized as none, occasionally, weekly, or daily. We defined ICH as any acute ICH detected by computed tomography scan. We evaluated the association between alcohol use frequency and ICH, adjusted for patient factors and head injury risk factors.ResultsOf 3128 study participants, 18.2% (n = 567) reported alcohol use: 10.3% with occasional use, 1.9% with weekly use, and 6.0% with daily use. ICH was more common in patients who used alcohol (20.5%, 22.0%, and 25.1% for occasional, weekly, and daily alcohol users, respectively, vs. 12.0% for non‐users, p < 0.001). The frequency of alcohol use was independently associated with ICH, adjusted for patient and head injury risk factors. The adjusted odds ratios (with 95% confidence intervals) for occasional, weekly, and daily alcohol users increased from 2.0 (1.5‒2.8) to 2.1 (1.1‒4.1) and 2.5 (1.7‒3.6), respectively, and showed the characteristics of dose‒response effect.ConclusionsAlcohol use in older adult emergency department patients with head trauma is relatively common. Self‐reported alcohol use appears to be associated with a higher risk of ICH in a dose‐dependent fashion. Fall prevention strategies may need to consider alcohol mitigation as a modifiable risk factor.

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Section: Methodsmentioning

confidence: 99%