A retrospective review of emergency admission for head injury in the over 75s.

Abstract

This study retrospectively reviewed all patients aged 75 years and over who were admitted to hospital following an acute head injury. All patients were cared for by general surgeons. The study period lasted for 2 years. Fifty five patients with a mean age of 83.8 years (range 75-97) were admitted. Four patients had a Glasgow Coma Score (GCS) of <13, all had intracranial injuries, only one being fit for neurosurgical intervention. Fifty one patients had a GCS greater than or equal to 13, 25 (49%) were admitted for social reasons, 10 (19.6%) for observation, 9 (17.6%) due to confusion and 7 (13.7%) due to other injuries. Patients spent a total of 366 days in surgical beds. Twenty five patients were discharged or transferred within 24h of admission and 30 patients remained in hospital for a total of 343 days, therefore, 54% of patients occupy 94% of the time spent in hospital. Of these 160 days were spent awaiting transfer to another hospital, 147 days waiting for social services, 24 days waiting for a terminal outcome and 12 days for unspecified reasons. Only 11 (38%) patients who suffered a fall of unknown cause underwent any follow-up investigations. Elderly patients with head injuries rarely require neurosurgical intervention. They often have co-existing medical conditions and complex social needs leading to prolonged hospital admission. The management of these patients might be more appropriately undertaken by physicians specializing in elderly care medicine.