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Age or Frailty: What Predicts Outcomes in Geriatric Patients With Rib Fractures?
Kevin Todd1, Joseph C L'Huillier2, Kabir Jalal3
1Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.
The Journal of Surgical Research
|March 26, 2026
Summary
Both advanced age and high frailty independently increase mortality risk in geriatric patients with rib fractures. Geriatric rib fracture care must address both chronological and physiological age for better outcomes.
Area of Science:
- Geriatric Trauma and Orthopedics
- Public Health and Epidemiology
Background:
- Geriatric patients with rib fractures face poor outcomes.
- The independent impact of age versus frailty on these outcomes is not well-established in large datasets.
Purpose of the Study:
- To determine if age, frailty, or their combination best predicts outcomes in geriatric patients with rib fractures.
- To analyze the independent association of age and frailty with mortality in this population.
Main Methods:
- Utilized the 2017-2023 TQIP database for geriatric patients (age ≥65) with rib fractures.
- Employed multivariate analysis with propensity score matching to compare outcomes based on frailty levels (modified frailty index).
- Conducted logistic regression controlling for covariates to assess the association between age, frailty, and mortality.
Main Results:
- Included 203,131 geriatric patients.
- High frailty was independently associated with increased mortality (OR: 1.806, P < 0.001) and worse outcomes.
- Advanced age was also independently associated with increased mortality (OR: 1.379, P < 0.001).
- High frailty correlated with longer hospital stays, higher ICU admissions, and more discharges to skilled nursing facilities.
Conclusions:
- Both advanced age and high frailty are independent predictors of higher mortality and adverse outcomes in geriatric rib fracture patients.
- Effective management requires addressing both chronological age and physiological frailty.
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