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This prospective observational study will examine the incidence of intracranial hemorrhage. The investigators will compare patients on anticoagulant and/or antiplatelet therapy with head trauma compared to patients not on these medications. While many studies have sought to quantify the incidence of intracranial hemorrhage in these patients, there is considerable controversy regarding their care and what to do after an initial negative head CT in anticoagulated geriatric patients who have experienced head trauma.
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| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with 14 Day ED Returns | Return visit to ED within 2 weeks | 14 days |
| Number of Participants with Primary Intracranial Hemorrhage | ICH on initial head CT scan | initial hospital visit |
| Number of Participants with Delayed Intracranial Hemorrhage | ICH on repeat CT scan | 14 days |
| Number of Participants with Hospitalizations at 14 days | If patient is admitted for any reason after initial ED visit | 14 days |
| Mortality of Participants | Death of patient from any cause at primary visit or up to 60 days from follow-up | 60 days |
| Measure | Description | Time Frame |
|---|---|---|
| New Symptoms | Any new symptoms | 60 days |
| Life alterations | Descriptive information from telephone interviews about how patients changed activities after head trauma |
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Inclusion Criteria: Patients seen in the emergency department for head trauma
Exclusion Criteria: Penetrating head trauma
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The Delray Medical Center and St. Mary's Medical Center emergency departments will be the major focal points for the study. These medical centers are located in Palm Beach County, Florida. Florida has the highest percentage of geriatric patients in the United States and, in particular, Palm Beach County has over 250,000 residents over the age of 65.
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| Name | Affiliation | Role |
|---|---|---|
| Richard Shih, MD | Florida Atlantic University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Delray Medical Center | Delray Beach | Florida | 33484 | United States | ||
| St. Mary's Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39271405 | Derived | Shih RD, Alter SM, Solano JJ, Engstrom G, Wells M, Clayton LM, Hughes PG, Goldstein LN, Azar FK, Ouslander JG. Low Incidence of Delayed Intracranial Hemorrhage in Geriatric Emergency Department Patients on Preinjury Anticoagulation Presenting with Blunt Head Trauma. J Emerg Med. 2024 Dec;67(6):e516-e522. doi: 10.1016/j.jemermed.2024.06.002. Epub 2024 Jun 13. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Jun 5, 2025 | |
| Reset | Jun 20, 2025 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jun 5, 2025 | Jun 20, 2025 |
| ID | Term |
|---|---|
| D006259 | Craniocerebral Trauma |
| ID | Term |
|---|---|
| D020196 | Trauma, Nervous System |
| D009422 | Nervous System Diseases |
| D014947 | Wounds and Injuries |
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| 60 days |
| New interventions since fall | Additional therapies or intervention instituted after minor head trauma | 60 days |
| West Palm Beach |
| Florida |
| 33407 |
| United States |