Please use this identifier to cite or link to this item: https://doi.org/10.1111/imj.13794
Title: Characteristics of fall-related traumatic brain injury in older adults
Authors: DESMOND TEO BOON SENG 
Wong, Hung C
Yeo, Ai W
Lai, Yi W
Choo, Ee L
RESHMA AZIZ MERCHANT 
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
frail elderly
accidental fall
brain injuries
traumatic
haematoma
subdural
head injuries
closed
EMERGENCY-DEPARTMENT VISITS
RISK-FACTORS
FUNCTIONAL DECLINE
SCREENING TOOL
PEOPLE
HOSPITALIZATION
IDENTIFICATION
VALIDATION
INCREASES
DISCHARGE
Issue Date: 1-Sep-2018
Publisher: WILEY
Citation: DESMOND TEO BOON SENG, Wong, Hung C, Yeo, Ai W, Lai, Yi W, Choo, Ee L, RESHMA AZIZ MERCHANT (2018-09-01). Characteristics of fall-related traumatic brain injury in older adults. INTERNAL MEDICINE JOURNAL 48 (9) : 1048-1055. ScholarBank@NUS Repository. https://doi.org/10.1111/imj.13794
Abstract: Background: Older adults admitted for falls and its complications, including traumatic brain injury (TBI), is increasing. Recent studies have shown that those with falls who presented to the emergency department (ED) had an increased frequency of ED revisits, especially those with head trauma. Aim: To determine the characteristics and predictors of fall-related traumatic brain injury (FRTBI) in older adults. Methods: Retrospective medical chart review of 339 patients aged 65 years and older admitted for TBI in 2014 due to a fall. Characteristics analysed include demographics, fall circumstances, prior ED visits, polypharmacy, readmission, functional status and specialist outpatient clinic utilisation before and after FRTBI. Results: A total of 339 (37.4%) patients admitted due to FRTBI was 65 years old and older; 112 (33.0%) for subdural haemorrhage (SDH); 227 (67.0%) for head injury (HI), with a mean age of 80 years. A total of 46 (41.1%) patients with SDH and 107 (47.1%) with HI had a previous ED visit within the last year, while 22 (19.6%) of SDH and 49 (21.6%) of HI had hospitalisation 3 months prior to FRTBI. FRTBI was associated with significant decline in activities of daily living, polypharmacy and increased specialist outpatient clinic appointments (P < 0.001). Mortality was 11 (3.2%). Mild cognitive impairment or dementia was significantly associated with admissions for FRTBI, 3.31 (95% confidence interval 1.68–6.51, P = 0.001) using adjusted logistic regression. Conclusion: FRTBI is associated with significant functional decline and increased resource utilisation with almost half of the patients having had prior ED visits or hospitalisation. Future studies should focus on falls risk assessment and interventions for high-risk older adults prior to discharge from ED and hospital, and its impact on readmissions due to FRTBI.
Source Title: INTERNAL MEDICINE JOURNAL
URI: https://scholarbank.nus.edu.sg/handle/10635/200591
ISSN: 1444-0903
1445-5994
DOI: 10.1111/imj.13794
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