Mortality prediction in geriatric patients with multiple trauma presenting by ambulance

The Modified 5-Factor Frailty Index (mFI-5) has been shown to predict complications following treatment in geriatric patients. However, few studies have compared the mFI-5 with other trauma scoring systems in cases involving multiple injuries. This study aimed to evaluate the Relationship Between mFI-5, Injury Severity Score (ISS), and Geriatric Trauma Outcome Score (GTOS) and their association with mortality in geriatric trauma patients.

This retrospective cohort study included patients aged 65 and older who were admitted to the emergency trauma unit of a tertiary care hospital. Data collected included laboratory parameters, imaging results, blood transfusion requirements, hospitalization status, intensive care unit admission, surgical intervention, ISS, GTOS, mFI-5 scores, and mortality outcomes.

A total of 241 patients were included, with a mean age of 78.12 (±8.34) years. Falls were the most common cause of trauma (n=142, 58.9%). Thoracic injuries were the most frequently observed (n=86, 53.7%). Patients who died within the first 24 hours of admission had significantly higher ISS (14.1 vs. 26.33), GTOS (119.02 vs. 157.33), and mFI-5 (2.53 vs. 3.33) scores (p=0.001, p=0.001, and p=0.017, respectively). Similar trends were noted for one-month and three-month mortality (p=0.001 for all).

Scoring systems are essential for early mortality prediction in geriatric trauma patients. ISS, GTOS, and mFI-5 scores have shown similar effectiveness in predicting comorbidities, intensive care unit admission, and mortality in geriatric trauma patients. ISS involves a complex calculation, while GTOS, although specifically designed for geriatric patients, requires additional computations based on the ISS. In contrast, mFI-5 may be more practical in emergency settings because it is easy to calculate.