Comparison of functional outcomes in elderly who have sustained a minor trauma with or without head injury: a prospective multicenter cohort study.
OBJECTIVE
The consequences of minor trauma involving a head injury (MT-HI) in independent older adults are largely unknown. This study assessed the impact of a head injury on the functional outcomes six months post-injury in older adults who sustained a minor trauma.


METHODS
This multicenter prospective cohort study in eight sites included patients who were aged 65 years or older, previously independent, presenting to the emergency department (ED) for a minor trauma, and discharged within 48 hours. To assess the functional decline, we used a validated test: the Older Americans' Resources and Services Scale. The cognitive function of study patients was also evaluated. Finally, we explored the influence of a concomitant injury on the functional decline in the MT-HI group.


RESULTS
All 926 eligible patients were included in the analyses: 344 MT-HI patients and 582 minor trauma without head injury. After six months, the functional decline was similar in both groups: 10.8% and 11.9%, respectively (RR=0.79 [95% CI: 0.55-1.14]). The proportion of patients with mild cognitive disabilities was also similar: 21.7% and 22.8%, respectively (RR=0.91 [95% CI: 0.71-1.18]). Furthermore, for the group of patients with a MT-HI, the functional outcome was not statistically different with or without the presence of a co-injury (RR=1.35 [95% CI: 0.71-2.59]).


CONCLUSIONS
This study did not demonstrate that the occurrence of a MT-HI is associated with a worse functional or cognitive prognosis than other minor injuries without a head injury in an elderly population, six months after injury.
*Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en vieillissement,Centre de recherche du CHU de Québec,Québec, QC.
Audrey-Anne
AA
Brousseau
*Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en vieillissement,Centre de recherche du CHU de Québec,Québec, QC.
Marcel
M
Émond
*Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en vieillissement,Centre de recherche du CHU de Québec,Québec, QC.
Marie-Josée
MJ
Sirois
The Canadian Emergency Department Team Initiative,Québec, QC.
Raoul
R
Daoust
The Canadian Emergency Department Team Initiative,Québec, QC.
Lauren E
LE
Griffith
The Canadian Emergency Department Team Initiative,Québec, QC.
Eddy
E
Lang
The Canadian Emergency Department Team Initiative,Québec, QC.
Jacques
J
Lee
The Canadian Emergency Department Team Initiative,Québec, QC.
Jeffrey J
JJ
Perry
Centre de Recherche et Centre Hospitalier Universitaire de Québec,Québec, QC.
Marie-Christine
MC
Ouellet
*Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en vieillissement,Centre de recherche du CHU de Québec,Québec, QC.
René
R
Verreault
Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Québec, QC.
Simon
S
Berthelot
Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Québec, QC.
Éric
É
Mercier
*Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en vieillissement,Centre de recherche du CHU de Québec,Québec, QC.
Nadine
N
Allain-Boulé
*Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en vieillissement,Centre de recherche du CHU de Québec,Québec, QC.
Valérie
V
Boucher
Axe Santé des Populations et Pratiques Optimales en santé,Unité de recherche en Traumatologie - Urgence - Soins Intensifs,Centre de recherche du CHU de Québec,Québec, QC.
Pier-Alexandre
PA
Tardif
Département de Médecine Familiale et Médecine d'Urgence,Université Laval,Québec, QC.
Natalie
N
Le Sage
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D016001:Confidence Intervals; D015577:Geriatric Assessment; D006801:Humans; D015601:Injury Severity Score; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy
cognitive status; elderly; functional outcomes; head injury; minor trauma