Antithrombotic Agent Use in Elderly Patients Sustaining Low-Level Falls.

Area of Science:

• Geriatric Trauma
• Pharmacology
• Neurological Surgery

Background:

• Elderly patients experiencing low-level falls represent a growing segment of trauma admissions.
• Evaluating antithrombotic agent use, injury patterns, and outcomes in this demographic is crucial, with a specific focus on intracranial hemorrhage (ICH).

Purpose of the Study:

• To determine the prevalence of antithrombotic agent use in elderly patients admitted after low-level falls.
• To analyze injury patterns and patient outcomes, particularly the incidence of ICH.
• To assess the association between antithrombotic use and ICH, as well as mortality rates.

Main Methods:

• Retrospective review of trauma registry data from 2007-2016 at a Level I trauma center.
• Inclusion criteria: patients aged 65 or older admitted following a low-level fall.
• Data analysis involved comparing outcomes between patients on and not on antithrombotic agents, stratified by ICH presence.

Main Results:

• Of 4074 elderly fall patients, 1153 (28.3%) had ICH and 1238 (30.4%) were on antithrombotics.
• Patients on antithrombotics had a significantly higher rate of ICH (35.9%) compared to those not on these agents (25.0%).
• Antithrombotic use, especially anticoagulants, was associated with higher mortality rates in patients with ICH.

Conclusions:

• Antithrombotic agent use is prevalent in elderly patients admitted for low-level falls and is associated with an increased risk of ICH.
• Anticoagulant use in this population is a significant risk factor for both ICH and increased mortality.