Citation

Teo DB, Wong HC, Yeo AW, Lai YW, Choo EL, Merchant RA. Intern. Med. J. 2018; 48(9): 1048-1055.

Affiliation

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1111/imj.13794

PMID

29573078

Abstract

AIM: To determine the characteristics of fall-related traumatic brain injury (FRTBI) in older adults.

METHODS: Retrospective medical chart review of 339 patients aged 65 years and older admitted for TBI in 2014 due to a fall. Characteristics analysed include demographics, fall circumstances, prior emergency department (ED) visits, polypharmacy, readmission, functional status, and specialist outpatient clinic (SOC) utilisation before and after FRTBI.

RESULTS: 339 (37.4%) patients admitted due to FRTBI were 65 years old and above, 112 (33.0%) for subdural haemorrhage (SDH); 227 (67.0%) for head injury (HI), with a mean age of 80 years. 46 (41.1%) patients with SDH and 107 (47.1%) with HI had a previous ED visit within the last year while 22 (19.6%) of SDH and 49 (21.6%) of HI had hospitalisation 3 months prior to FRTBI. FRTBI was associated with significant decline in activities of daily living, polypharmacy and increased SOC appointments (P < 0.001). Mortality was 11 (3.2%). Mild cognitive impairment or dementia was significantly associated with admissions for FRTBI, 3.31 (95% CI 1.68 - 6.51, P = 0.001) using logistic regression.

CONCLUSIONS: FRTBI is associated with significant functional decline and increased resource utilisation with almost half of the patients had prior ED visits or hospitalisation. Future studies should focus on falls risk assessment and interventions for high risk older adults prior to discharge from ED and hospital, and its impact on readmissions due to FRTBI.

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Language: en

Keywords

accidental falls; brain injuries, traumatic; frail elderly; head injuries, closed; hematoma, subdural