Related Experiment Video
Updated: Jul 8, 2025
Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
Published on: July 26, 2024
Frailty is associated with long-term outcomes in older trauma patients: A prospective cohort study
Sarah Ibitoye1, Lily Bridgeman-Rutledge2, Roxanna Short3
1CLARITY (Collaborative Ageing Research group), North Bristol NHS Trust, United Kingdom.
Background:
Most major trauma admissions are older adults, many of whom are living with frailty - a recognised risk factor for post-injury mortality.
Objectives:
To describe the effect of frailty, and geriatrician review on mortality up to 4-years after hospitalisation following trauma.
Methods:
This prospective cohort study included patients 65 years or older admitted to North Bristol NHS Trusts' Major Trauma Centre from November 2018 to September 2019. The primary outcome was time-to-mortality, assessed with an adjusted multivariable Cox regression model. Analyses were adjusted for factors known to be associated with mortality including age, sex, comorbidities, injury factors, surgical procedure, and complications.
Results:
573 patients were included: median age was 81 years; 67.5 % were living with frailty (Clinical Frailty Scale, CFS 4-8). Mortality was 45.2 % at the end of the study. Compared to fit patients (CFS 1-2), risk of death increased in those living with very mild frailty (CFS 4; aHR 3.22 [95 % CI 1.53-6.77]), mild frailty (CFS 5; aHR 4.97 [95 % CI 2.40-10.28]), moderate frailty (CFS 6; aHR 5.94 [95 % CI 2.83-12.44]), and moderate to severe frailty (CFS 7-8; aHR 9.63 [95 % CI 4.35-21.32]). Geriatrician review was associated with less mortality (aHR 0.55, 95 % CI 0.38-0.79).
Conclusions:
Frailty predicts long-term mortality in older trauma. Our findings have implications for clinician-patient discussions of prognosis and therapy goals. Furthermore, our results lend support to the routine provision of geriatrician input in trauma pathways.
