Physician
Elizabeth Sejr Viskum
Department of Orthopedic surgery, Odense University Hospital
| Projekt styring | ||
| Projekt status | Open | |
| Data indsamlingsdatoer | ||
| Start | 28.05.2025 | |
| Slut | 01.03.2027 | |
Admission or Discharge? A Comparison of Outcomes for Anticoagulated Patients with Head Trauma and a Normal CT Scan
Short summary
Abstract: This study compares outcomes in anticoagulated patients aged 65+ with head trauma and a normal CT scan, evaluating whether immediate discharge increases the risk of complications or death within 30 days versus 24-hour hospital observation. Patient records from two periods-during and after the COVID-19 pandemic-will be reviewed to assess safety and inform future clinical practice.
Rationale
Background: When people on anticoagulant medication suffer a head injury, there is an increased risk that they may develop a brain hemorrhage. Therefore, they are examined in the hospital with a CT scan of the brain to check for bleeding or other injuries. CT scans are good at detecting acute bleeding, but it remains uncertain whether patients with a normal CT scan are better off staying in the hospital for observation or can safely be sent home immediately. This is especially relevant for elderly patients or those with dementia, who may struggle with being hospitalized and possibly fare better at home in familiar surroundings. Furthermore, it is rare that 24-hour hospital observation changes the outcome. During the COVID-19 pandemic, it became common to discharge patients after a normal CT scan to reduce hospital admissions and thereby limit the spread of infection. Aim: We aim to investigate whether patients taking anticoagulant medication who suffer head trauma have a higher risk of developing complications if they are discharged immediately after a normal CT scan compared to if they remain in the hospital for 24 hours of observation following a normal CT scan. Secondarily, we will examine whether those who are not admitted have a higher risk of dying within 30 days after discharge.
Description of the cohort
The study will be conducted by reviewing patient records from two periods: May 2024-April 2025 (post-COVID) and October 2020-September 2021 (during COVID). All patients over 65 years old with a head injury (diagnosis code DS00* and DS060) who were on blood-thinning medication and underwent CT scanning will be included. In the first period, patients were admitted for 24 hours of observation, whereas in the second period, due to COVID, they were discharged immediately if the scan was normal. We will examine their records to see if they developed a brain hemorrhage or died within 30 days after their initial contact with the hospital.
Data and biological material
Data from the patient journal