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The following is a summary of “Risk factors for clinically important traumatic brain injury in minor head injury in older people,” published in the June 2024 issue of Emergency Medicine by Uchiyama, et al.

With the growing older population, the incidence of traumatic brain injury (TBI) among elderly individuals is on the rise. While the implications of minor head injuries for older adults, including the necessity for medical interventions and hospitalizations, have not been extensively explored, for a study, researchers sought to identify the risk factors for clinically important traumatic brain injury (ciTBI) in older patients presenting with minor head injuries.

The retrospective, single-center cohort study examined patients aged 65 years or older who arrived at the hospital with a head injury and had a Glasgow Coma Scale (GCS) score of 13 or higher between January 1, 2018, and October 31, 2021. Patients with a history of head injury lasting 24 hours or more were excluded from the study. The primary outcome of interest was ciTBI, defined as the occurrence of death, the need for surgical intervention, intubation, significant medical treatments, or hospital stays of 2 or more nights. Multiple logistic regression analysis was used to identify risk factors associated with ciTBI.

Out of the 296 patients initially included in the study, 6 were excluded from the analysis. Among the remaining patients, ciTBI was identified in 62 cases. The logistic regression analysis indicated that a GCS score of 14 or less was associated with a significantly increased risk of ciTBI, with an odds ratio (OR) of 3.72 (95% CI 1.89–7.30). Additionally, high-risk mechanisms of injury were found to be a risk factor for ciTBI with an OR of 2.80 (95% CI 1.39–5.64). Vomiting was identified as another risk factor, with an OR of 5.01 (95% CI 1.19–21.1), and retrograde amnesia was also a significant risk factor, with an OR of 6.90 (95% CI 3.37–14.1).

In older patients with minor head injuries, factors such as a GCS score of 14 or lower, high-risk mechanisms of injury, vomiting, and retrograde amnesia were found to be significant risk factors for clinically important traumatic brain injury (ciTBI). The findings highlighted the need for careful assessment of these risk factors to improve clinical decision-making and guide the management of older adults presenting with minor head injuries.

Reference: sciencedirect.com/science/article/pii/S0735675724001591