Ann Geriatr Med Res 2016; 20(4): 221-228  http://dx.doi.org/10.4235/agmr.2016.20.4.221
Risk of Traumatic Intracranial Hemorrhage From Low-Energy Falls in the Oldest-Old Patients
Sung Kyu Kim1, Ki Young Jeong1, Jong Seok Lee1,2, Han Sung Choi1,2, Hoon Pyo Hong1,2, Young Gwan Ko1,2
1Department of Emergency Medicine, Kyung Hee University Hospital, Seoul, 2Department of Emergency Medicine, Kyung Hee University School of Medicine, Seoul, Korea
Correspondence to: Han Sung Choi, MD 
Department of Emergency Medicine, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea 
Tel: +82-2-958-8275 
Fax:+82-2-958-9689 
E-mail: hsg3748@hanmail.net
Published online: December 31, 2016.
© The Korea Geriatrics Society. All rights reserved.

Abstract
Background: The population of individuals classified as oldest-old (aged ≥85 years) has increased rapidly in recent years. The rates of morbidity from chronic diseases and physical dependence tend to be higher in the oldest-old compared with individuals classified as young-to-middle-old (aged 65-84 years). Therefore, the classification and evaluation of traumatic injuries in the oldest-old group are necessary. Herein we focused on the risk of traumatic intracranial hemorrhage from low-energy falls in older patients. 
Methods: Patient medical records from the Emergency Department after low-energy falls that occurred between November 2014 and April 2016 were retrospectively analyzed. Patients were divided into an older group (aged ≥65 years) and an adult group (aged 18-64 years); the older group was subdivided into the oldest-old group (aged ≥85 years) and a young-to-middle-old group (aged 65-84 years). The rate of intracranial hemorrhage and related factors were also investigated. 
Results: The older group had a greater risk of traumatic intracranial hemorrhage than the adult group (20% vs. 12.6%, p=0.019). Furthermore, more cases of traumatic intracranial hemorrhage were found in the oldest-old group than in the young-to-middle-old group (37.5% vs. 18.0%, p=0.024). Similarly, the risk of traumatic intracranial hemorrhage in the oldest-old was higher than in the young-to-middle-old group (p=0.032). 
Conclusion: The risk of traumatic intracranial hemorrhage from low-energy falls in the oldest-old patients was higher than in the young-to-middleold patients. Therefore, physicians need to pay particular attention to oldest-old patients, even to those with mental integrity and without neurological deficits.
Keywords: Oldest old, Accidental falls, Intracranial hemorrhage, Emergency


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