Brousseau Audrey-Anne, Émond Marcel, Sirois Marie-Josée, Daoust Raoul, Griffith Lauren E, Lang Eddy, Lee Jacques, Perry Jeffrey J, Ouellet Marie-Christine, Verreault René, Berthelot Simon, Mercier Éric, Allain-Boulé Nadine, Boucher Valérie, Tardif Pier-Alexandre, Le Sage Natalie
*Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en vieillissement,Centre de recherche du CHU de Québec,Québec, QC.
The Canadian Emergency Department Team Initiative,Québec, QC.
CJEM. 2017 Sep;19(5):329-337. doi: 10.1017/cem.2016.368. Epub 2016 Sep 9.
The consequences of minor trauma involving a head injury (MT-HI) in independent older adults are largely unknown. This study assessed the impact of a head injury on the functional outcomes six months post-injury in older adults who sustained a minor trauma.
This multicenter prospective cohort study in eight sites included patients who were aged 65 years or older, previously independent, presenting to the emergency department (ED) for a minor trauma, and discharged within 48 hours. To assess the functional decline, we used a validated test: the Older Americans' Resources and Services Scale. The cognitive function of study patients was also evaluated. Finally, we explored the influence of a concomitant injury on the functional decline in the MT-HI group.
All 926 eligible patients were included in the analyses: 344 MT-HI patients and 582 minor trauma without head injury. After six months, the functional decline was similar in both groups: 10.8% and 11.9%, respectively (RR=0.79 [95% CI: 0.55-1.14]). The proportion of patients with mild cognitive disabilities was also similar: 21.7% and 22.8%, respectively (RR=0.91 [95% CI: 0.71-1.18]). Furthermore, for the group of patients with a MT-HI, the functional outcome was not statistically different with or without the presence of a co-injury (RR=1.35 [95% CI: 0.71-2.59]).
This study did not demonstrate that the occurrence of a MT-HI is associated with a worse functional or cognitive prognosis than other minor injuries without a head injury in an elderly population, six months after injury.
在独立生活的老年人中，轻度创伤性头部损伤（MT-HI）的后果在很大程度上尚不清楚。本研究评估了头部损伤对遭受轻度创伤的老年人受伤后六个月功能结局的影响。
这项在八个地点进行的多中心前瞻性队列研究纳入了年龄在65岁及以上、以前独立生活、因轻度创伤到急诊科就诊并在48小时内出院的患者。为了评估功能下降情况，我们使用了一项经过验证的测试：美国老年人资源与服务量表。还对研究患者的认知功能进行了评估。最后，我们探讨了合并损伤对MT-HI组功能下降的影响。
所有926名符合条件的患者均纳入分析：344名MT-HI患者和582名无头部损伤的轻度创伤患者。六个月后，两组的功能下降情况相似：分别为10.8%和11.9%（相对危险度=0.79[95%置信区间：0.55-1.14]）。轻度认知障碍患者的比例也相似：分别为21.7%和22.8%（相对危险度=0.91[95%置信区间：0.71-1.18]）。此外，对于MT-HI患者组，有无合并损伤的功能结局在统计学上无差异（相对危险度=1.35[95%置信区间：0.71-2.59]）。
本研究未表明，在老年人群中，受伤六个月后，MT-HI的发生与比其他无头部损伤的轻度损伤更差的功能或认知预后相关。
