New Study Questions the Risk of Brain Bleeding from Blood Thinners in Older Adults After Falls

As the population of older adults continues to grow, concerns about the safety of blood-thinning medications like warfarin after falls have been prominent. It has long been assumed that high levels of anticoagulation significantly increase the risk of brain hemorrhages following head injuries. However, a recent study conducted by researchers at Florida Atlantic University challenges this assumption.

The study analyzed 2,686 older adults admitted to two trauma centers in South Florida over the course of a year. All participants had experienced a fall, and researchers compared outcomes between those on warfarin, a common blood thinner, and those not using any anticoagulants. The findings revealed that being on warfarin, even with elevated INR levels, did not substantially elevate the risk of intracranial bleeding. Interestingly, patients with poorly controlled, low warfarin activity exhibited higher bleeding risks. Overall, about 11% of the patients suffered brain bleeds after trauma, with non-anticoagulated patients showing a 6% bleeding rate and warfarin users around 7%. Notably, patients with INR levels below the therapeutic range experienced the highest bleeding rates, up to nearly 20%. Meanwhile, no brain bleeds were observed in patients with dangerously high INR levels above 5.

Lead researcher Dr. Richard Shih emphasized that these results suggest that overly cautious management or avoidance of anticoagulation might not be necessary. Instead, proper regulation and monitoring of blood-thinning levels could be more effective in reducing complications. The study indicates that current emergency care protocols may need reassessment to better balance bleeding risks and the benefits of stroke prevention. Follow-up procedures, including CT scans and patient monitoring, can be optimized based on these insights.

In conclusion, the findings advocate for a nuanced approach to anticoagulation management in older adults post-fall, highlighting that well-controlled blood-thinning therapy may not pose as high a risk as previously thought. This research promises to influence clinical guidelines, improve patient outcomes, and reduce unnecessary healthcare costs.

Source: https://medicalxpress.com/news/2025-07-refutes-blood-thinner-brain-falls.html