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Elderly Patients Are More Likely to Experience Intracranial Bleeding After Mild Traumatic Brain Injury

Traumatic brain injury (TBI) is a serious public health concern, affecting an estimated 70 million people worldwide every year. As quality of life and medical advances continue to extend the average expected lifespan, researchers have aimed to study the effects of TBI among the rapidly growing elderly population. Elderly people are particularly vulnerable to TBI because the risk of accidental falls increases substantially in old age, and researchers and clinicians need to understand age-specific TBI risk factors and treatment challenges so they can design effective, targeted injury management and recovery plans for elderly people.

A research team in Italy recently studied health outcomes and other patient characteristics among 1,094 elderly people (aged 75 and older) who were admitted to an emergency department with mild TBI. They compared the elderly population to a group of 1,231 younger patients who sustained similar injury. Compared to the younger patients, the researchers found that elderly patients were significantly more likely to:

  • Experience intracranial hemorrhage, or severe brain bleeding.
  • Be admitted to the hospital for their injuries, and were more likely to be readmitted within 30 days of leaving the hospital.
  • Take other medications that might interfere with TBI treatment.
  • Take anticoagulant medications, which thin the blood to prevent formation of blood clots.

The researchers also found that for every additional year of age, patients were 2% more likely to experience brain bleeding after mild TBI. Additionally, after reaching age 75, the risk of intracranial hemorrhage increased by 180%, indicating that elderly people are at serious risk for brain bleeds, even when the head injury was mild. The researchers statistically controlled their analysis to account for increased anticoagulant medication use among elderly people, so the increased bleeding risk can be attributed to age alone.

Not only are elderly people at high risk for sustaining TBI from falls, their health outcomes after TBI are significantly worse than those of younger people. Clinicians are urged to closely monitor all elderly patients for signs of intracranial hemorrhage and to design specialized recovery plans that account for use of anticoagulants and other medications associated with old age.

Savioli G, Ceresa IF, Ciceri L, et al. Mild head trauma in elderly patients: Experience of an emergency department. Heliyon. (June 2020).


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