Hofmann Valeska, Deininger Christian, Döbele Stefan, Konrads Christian, Wichlas Florian
BG Trauma Centre, Department of Trauma and Reconstructive Surgery, University of Tübingen, 72076 Tübingen, Germany.
Department of Orthopedics and Traumatology, University Hospital Salzburg, 5020 Salzburg, Austria.
J Clin Med. 2021 Aug 25;10(17):3794. doi: 10.3390/jcm10173794.
Fall-related hospitalizations among older adults have been increasing in recent decades. One of the most common reasons for this is minimal or mild traumatic brain injury (mTBI) in older individuals taking anticoagulant medication. In this study, we analyzed all inpatient stays from January 2017 to December 2019 of patients aged > 75 years with a mTBI on anticoagulant therapy who received at least two cranial computer tomography (cCT) scans. Of 1477 inpatient stays, 39 had primary cranial bleeding, and in 1438 the results of initial scans were negative for cranial bleeding. Of these 1438 cases, 6 suffered secondary bleeding from the control cCT scan. There was no significance for bleeding related to the type of anticoagulation. We conclude that geriatric patients under anticoagulant medication don't need a second cCT scan if the primary cCT was negative for intracranial bleeding and the patient shows no clinical signs of bleeding. These patients can be dismissed but require an evaluation for need of home care or protective measures to prevent recurrent falls. The type of anticoagulant medication does not affect the risk of bleeding.
近几十年来，老年人因跌倒而住院的情况一直在增加。最常见的原因之一是服用抗凝药物的老年人发生轻微或轻度创伤性脑损伤（mTBI）。在本研究中，我们分析了2017年1月至2019年12月期间年龄大于75岁、接受抗凝治疗且发生mTBI并至少接受过两次头颅计算机断层扫描（cCT）的患者的所有住院病例。在1477例住院病例中，39例有原发性颅内出血，1438例初次扫描结果为颅内出血阴性。在这1438例病例中，6例在对照cCT扫描时出现继发性出血。出血与抗凝类型无关。我们得出结论，如果初次cCT扫描颅内出血为阴性且患者无出血临床体征，服用抗凝药物的老年患者无需进行第二次cCT扫描。这些患者可以出院，但需要评估是否需要家庭护理或采取防护措施以防止再次跌倒。抗凝药物的类型不影响出血风险。
