The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56927

Erin Ruppe, MPH, Kerry Brunight, PhD, and Laura Mosqueda, MD. Department of Medicine, Program in Geriatrics, University of California, Irvine, 101 The City Drive, Pavilion III, ZC 1150, Orange, CA 92868, (714) 456-2951, eruppe@uci.edu

Purpose: By understanding accidental bruising patterns in the elderly we can start to identify bruises that are more likely to signal abuse. The size, location, color, and resolution of normal bruises were documented and correlated with functional status. Methods: Subjects were recruited from two independent living facilities and one skilled nursing facility. Subjects were screened daily head-to-toe for new bruises. Once a new bruise was identified its location, color, and size were recorded and photographed daily until resolution. Demographic data, medications, mobility, and cognitive information were collected. Results: Of 67 subjects, 45 were found to have bruises. A total of 58 bruises were found with10 subjects having 2 bruises and 2 subjects with 3 bruises. All the bruises except 4 were on the extensor surfaces of the extremities. Red and purple were the predominant colors initially but began to fade by day 10. Only 2 bruises persisted beyond day 18. Black occurred occasionally at the beginning, blue was rare, and both faded by day 11. Yellow was rare at day 1, it grew to a peak at day 6 and began fading at day 12. The mean age was 87 years old. Subjects had a mean of 3.06 prescription medications and 1.95 over-the-counter medications. Conclusion: Natural bruises in the elderly occur almost exclusively on extensor surfaces of the extremities. The presence of black or blue color suggests the bruise is less than 12 days old, and the presence of yellow suggests the bruise is more than 24 hours old.

Learning Objectives:

• Begin to recognize the difference between accidental bruises in the elderly and suspicious looking bruises which could signal abuse.
• Apply the results to potential abuse cases.
• Recognize the growing problem of elder abuse in the United States and the need for more research.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.