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Closed head injury in elderly and nonelderly patients.

AIM
To investigate differences in clinical presentation between elderly and nonelderly patients with traumatic closed head injury (CHI).


METHODS
A retrospective chart review was used to compare the initial presentation of elderly versus nonelderly adult patients evaluated at two trauma centers with a final diagnosis of CHI confirmed by computed tomography (CT).


RESULTS
Of 171 patients who met inclusion criteria, 114 (67%) were placed in the nonelderly group and 57 (33%) in the elderly group. Loss of consciousness was reported in 28 patients (49%) in the elderly group compared to 76 patients (67%) in the nonelderly group (diff = 0.18, 95% confidence interval [CI] 0.02-0.34).


CONCLUSION
Elderly patients with traumatic CHI appear to experience loss of consciousness less frequently than nonelderly patients. Loss of consciousness should not be the sole determinant of the need for CT in elderly patients with head trauma.