A 7-year Retrospective Evaluation of Judicial Cases of Patients Over 75 Years of Age, Except Traffic Accidents

Objective This study aimed to evaluate the clinical, demographic, and forensic characteristics of non–traffic-related forensic cases among individuals aged ≥ 75 years, and to identify injury patterns and admission behaviors that may indicate elder abuse. Methods This retrospective, descriptive study included 160 patients aged ≥ 75 years who presented to the Emergency Department (ED) of Kayseri State Hospital between 1 June 2018 and 15 August 2025 and were recorded as non–traffic-related forensic cases. Demographics, comorbidities, type of incident, injury characteristics, time and manner of presentation, and clinical outcomes were obtained from electronic medical records and forensic documentation. Results Among 3,040,767 ED visits and 43,451 forensic case registrations during the seven-year period, 160 patients met the inclusion criteria. The mean age was 79.98 ± 4.69 years, and 55% were female. Comorbidities were present in 74.3% of patients. Assault was the predominant cause of forensic presentation (80.6%), with injuries most commonly involving the head–neck and upper extremities. Abrasions (42.5%) and contusions (24.4%) were the most frequent physical findings. A striking 78.8% of patients attempted to conceal the incident, and ED presentations predominantly occurred between 16:00 and 00:00. Recurrent ED visits were identified in 13.8% of cases, suggesting ongoing or repetitive abuse. Most patients were discharged (84.4%), and the overall mortality rate was 2.5%. Conclusion Non–traffic-related forensic presentations in individuals aged ≥ 75 years are predominantly assault-related, with injury patterns strongly suggestive of elder abuse. Head–neck trauma, inconsistent history, concealed reporting, and recurrent presentations represent key red flags for clinicians. These findings highlight the critical need for heightened forensic awareness, systematic screening, and a multidisciplinary approach to the evaluation and management of suspected elder abuse in the very elderly population.