UMEM Educational Pearls

This secondary analysis of the NEXUS head injury data found patients over 65:

-sustained more significant injuries than younger pts

-presented more frequently with occult injuries

-when they required neurosurgery intervention only 16% went home, 32% were discharged to rehab facility and 41%  died

-mechanism of injury was most commonly fall from standing

-mortality rates were highest for fall from ladder and auto vs. pedestrian injuries

The authors concluded: “Older blunt head injury patients are at high risk of sustaining serious intracranial injuries even with low-risk mechanisms of injury, such as ground-level falls. Clinical evaluation is unreliable and frequently fails to identify patients with significant injuries. Outcomes, particularly after intervention, can be poor, with high rates of long-term disability and mortality.”


William R. Mower, Thomas E. Akie, Naseem Morizadeh, Malkeet Gupta, Gregory W. Hendey, Jake L. Wilson, Lorenzo Pierre Leonid Duvergne, Phillip Ma, Pravin Krishna, Robert M. Rodriguez,
Blunt Head Injury in the Elderly: Analysis of the NEXUS II Injury Cohort,
Annals of Emergency Medicine,