(O-B2) An Observational study to Compare the Incidence of traumatic intracranial Haemorrhage in Elderly patients on Anticoagulants Compared to those with Either LOC or PTA

Objectives: The aim of the study was to determine the incidence of traumatic intracranial haemorrhage in patients over 65 years of age comparing those on anticoagulants versus those with either LOC or PTA over a twelve-month period.

Background: Classical risk factors for traumatic intracranial haemorrhage are well established. Warfarin is thought to carry an increased risk for of traumatic intracranial bleeding; with an odds ratio of approximately two. More recent studies have suggested that the risk of intracranial haemorrhage may not been quite as high as originally thought.

Methods: Elderly patients over 65 years of age with a head injury were included in the study if they had documented evidence of being on an anticoagulant (Warfarin or NOAC) or documented evidence of either LOC or PTA. The study included patients who underwent a trauma CT head performed during the period September 2020 to August 2021. North Manchester General Hospital is a non trauma centre but does see a large number of elderly fallers. The majority of elderly fallers with head injuries under go a CT head. Patients requiring a pan trauma CT were excluded from the study. Patients with other criteria other than those included above were also excluded from this observational study.

Results: During the study period September 2020 to August 2021, 516 patients underwent a trauma CT head. Of these 197 patients met the inclusion criteria. A total of thirteen patients had a positive scan. Eighty patients of the 197 patients were found to be on anticoagulants and of these three had a positive scan (1.5%). One hundred and seventeen patients had either LOC or PTA of these 10 patients had a positive scan (8.5%). The standard chi squared test (X2 = 1.7739) was found not be statistically significant p=0183 p < 0.5%

Conclusions: Despite the fact that early studies suggest that anticoagulants, namely warfarin was a high risk factor for intracranial bleeding the results of this study suggest that anticoagulants may not be a significant risk factor for intracranial bleeds when compared to other medium risk factors in elderly fallers.

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Funding (Optional): None