After an older person falls, even if they appear all right, they may still be at risk of delayed intracranial hemorrhaging — or post-injury brain bleeding. But, the rate at which these incidents actually occur may be lower than originally estimated, according to a study from Boca Raton-based Florida Atlantic University's Schmidt College of Medicine.
There was also little to no difference in the rate of post-fall brain bleeding in patients who were taking anticoagulants — or blood thinners — compared to patients who were not, according to the results, which were published June 13 in the Journal of Emergency Medicine.
Past studies have determined that an older adult who is also taking blood thinners and sustains a head injury had a 7.2% risk for delayed ICH, according to a June 25 news release from Florida Atlantic University.
"If anticoagulated head trauma patients had this relatively high frequency of delayed intracranial hemorrhages previously reported, then routine repeat head CT scans in all cases at 24 hours would require a substantial change in current practice in emergency departments," Richard Shih, MD, senior author of the study and professor of emergency medicine at the Florida Atlantic University Schmidt College of Medicine stated in the release. "Because of this controversial issue, our objective was to perform a larger prospective study to validate or refute these findings."
The research, Dr. Shih said, could influence "guidelines and practices regarding observation and imaging protocols" related to CT scans because of the new data.
Dr. Shih and his team conducted the study with 3,425 patients over the age of 65 who also had acute head injuries at two different hospitals between August 2019 and July 2020.
"While cases of clinically significant delayed [intracranial hemorrhaging] in older ED patients with blunt head trauma do occur, they appear to be infrequent," Dr. Shih and his team wrote in their conclusion. "They are typically diagnosed one to two days and up to five days after the initial CT scan, potentially limiting the need for longer-term follow-up on many patients."