From the Guidelines
No, BESSI (Balance Error Scoring System, International) does not increase the risk of intracranial injury after a fall. BESSI is a screening tool used to evaluate balance and balance errors in patients, particularly those who have experienced trauma such as falls. The evidence provided does not suggest that BESSI itself increases the risk of intracranial injury after a fall. However, it's essential to understand that falls can be a significant risk factor for intracranial injuries, especially in older adults or individuals with certain medical conditions.
Some key points to consider:
- Falls are a leading cause of injury and death in older adults, and the risk of falls increases with age 1.
- Anticoagulant and antiplatelet therapy can increase the risk of intracranial hemorrhage after a fall, but the risk of delayed intracranial hemorrhage is relatively low 2.
- Patient education and counseling are crucial in preventing falls and reducing the risk of intracranial injuries, especially in individuals with a history of falls or balance disorders 3.
- Interdisciplinary rehabilitation teams should work together to identify individual risk factors for falls and develop strategies to minimize falls during daily activities 4.
In conclusion, while BESSI itself does not increase the risk of intracranial injury after a fall, it's essential to consider the underlying risk factors for falls and intracranial injuries, such as age, medical conditions, and anticoagulant therapy, and to develop strategies to prevent falls and minimize the risk of intracranial injuries. The most recent and highest quality study, 2, suggests that the risk of delayed intracranial hemorrhage after a fall is relatively low, and that patient education and counseling are crucial in preventing falls and reducing the risk of intracranial injuries.
From the Research
Risk of Intracranial Injury after a Fall
- The provided studies do not directly address the question of whether BESSI (Balance Error Scoring System, International) increases the risk of intracranial injury after a fall 5, 6, 7, 8, 9.
- However, several studies discuss the risk of intracranial hemorrhage (ICH) in relation to anticoagulant use and falls in the elderly population 5, 6, 7, 8.
- One study found that patients on direct oral anticoagulants (DOACs) had lower ICH expansion rates and favorable outcomes compared to those on vitamin K antagonists (VKAs) after a fall 5.
- Another study reported that DOACs were an overall safer alternative to warfarin for patients at high risk of falls, with lower rates of ICH progression and functional dependency at discharge 7.
- A systematic review and meta-analysis found that DOACs reduced the risk of ICH by 41-60% compared to VKAs, and had a similar risk of ICH compared to low-molecular-weight heparins and aspirin 8.
- A study on aging, diabetes, and falls found that older adults with type 2 diabetes are at increased risk of falling due to factors such as hypertension, diabetes, pain, and polypharmacy, but did not specifically address the risk of intracranial injury after a fall 9.