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Updated: Feb 4, 2026

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Frailty predicts mortality and complications in chronologically young patients with traumatic orthopaedic injuries

Rahul M Rege1, Robert P Runner2, Christopher A Staley2

  • 1Emory University, School of Medicine, 1648 Pierce Dr. NE, Atlanta, GA 30307, United States.

Injury
|October 3, 2018
PubMed

Insights

The modified frailty index (mFI) effectively predicts mortality and complications in younger patients with orthopaedic trauma. This tool aids in individualized risk assessment for better patient outcomes.

Area of Science:

  • Orthopaedic Surgery
  • Trauma Care
  • Geriatric Medicine

Background:

  • Rising morbidity and mortality in traumatic orthopaedic injuries necessitates improved complication prediction.
  • Frailty indices are validated predictors in various surgical fields, primarily in geriatric populations.
  • Limited evidence exists on frailty in younger, non-geriatric trauma patients.

Purpose of the Study:

  • To evaluate the modified frailty index (mFI) as a predictor of mortality and complications.
  • To assess the mFI's role in patients of all ages undergoing surgery for pelvic, acetabular, and lower extremity trauma.

Main Methods:

  • Utilized the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2005-2014).
  • Analyzed 56,241 patients, divided into geriatric (≥60 years) and young (<60 years) cohorts.
  • Calculated mFI, performing bivariate and multivariate analyses with logistic regression and chi-square tests.

Main Results:

  • The mFI strongly predicted 30-day mortality in the young cohort (OR 11.02, p<0.001).
  • mFI was also a significant predictor of Clavien-Dindo grade IV complications in younger patients (OR 28.82, p<0.001).

Conclusions:

  • The mFI is a significant predictor of morbidity and mortality in chronologically young orthopaedic trauma patients.
  • mFI facilitates individualized risk assessment for perioperative counseling and outcome improvement.
Abstract

Keywords:
FrailtyModified frailty indexOrthopaedic traumaPerioperative managementPost-operative outcomesYoung

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