Two hundred thirty-one patients older than 60 years of age, who arrived at the emergency department with a mild or moderate
head injury (Glasgow Coma Scale [GCS] Scores 13-15 and 9-12, respectively), were included in the study. One hundred ten patients were receiving prophylactic LDA (100 mg/day) and these formed the
aspirin-treated group. One hundred twenty-one patients were receiving
no aspirin, and these formed the control group. There was no statistically significant difference between the two groups with respect to age, sex, mechanism of
trauma, or GCS score on arrival at the emergency department. Most of the patients sustained the
head injury from falls (88.2% of patients in the
aspirin-treated group and 85.1% of patients in the control group), and had external signs of
head trauma such as bruising or scalp
laceration (80.9% of patients in the
aspirin-treated group and 86.8% of patients in the control group). All patients underwent similar neurological examinations and computerized tomography (CT) scanning of the head. The CT scans revealed evidence of
traumatic intracranial hemorrhage in 27 (24.5%) patients in the
aspirin-treated group and in 31 patients (25.6%) in the control group. Surgical intervention was required for five patients in each group (4.5% of patients in the
aspirin-treated group and 4.1% of patients in the control group). A surprising number of the patients who arrived with GCS Score 15 were found to have
traumatic intracranial hemorrhage, as revealed by CT scanning (11.5% of patients in the
aspirin-treated group and 16.5% of patients in the control group). Surgery, however, was not necessary for any of these patients.
CONCLUSIONS: There was no statistically significant difference in the frequency or types of
traumatic intracranial hemorrhage between patients who had received
aspirin prophylaxis and those who had not. The authors conclude that LDA does not increase surgically relevant parenchymal or meningeal
bleeding following moderate and
minor head injury in patients older than 60 years of age.