RT Journal Article
SR Electronic
T1 Head injury in the elderly – an overview for the physician
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 177
OP 184
DO 10.7861/clinmedicine.19-2-177
VO 19
IS 2
A1 William Beedham
A1 George Peck
A1 Simon E Richardson
A1 Kevin Tsang
A1 Michael Fertleman
A1 David JH Shipway
YR 2019
UL http://www.rcpjournals.org/content/19/2/177.abstract
AB Head injury is a common cause for hospital admission and additionally 250,000 UK inpatients fall during hospital admissions annually. Head injury most commonly occurs as a result of falls from standing height in older adults. Older adults are frequently frail and multi-morbid; many have indications for anticoagulation and antiplatelet agents. The haemorrhagic complications of head injury occur in up to 16% of anticoagulated patients sustaining a head injury. These patients suffer adverse outcomes from surgery as a result of medical complications. Although geriatric trauma models are evolving to meet the demand of an ageing trauma population, medical support to trauma services is commonly delivered by general physicians, many of whom lack experience and training in this field. Determining the role of surgery and interrupted anticoagulation requires careful personalised risk assessment. Appreciation of the opposing risks can be challenging; it requires an understanding of the evidence base in both surgery and medicine to rationalise decision making and inform communication. This article aims to provide an overview for the physician with clinical responsibility for patients who have sustained head injury.