Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Influence of frailty on short-term mortality in older patients with multiple trauma in the emergency department.
Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the association between frailty and 28-day mortality in older patients presenting to the emergency department with multiple trauma and to assess the discriminative performance of PRISMA-7 and the Trauma-Specific Frailty Index (TSFI) in frailty assessment in relation to commonly used trauma severity scores.
methodsThis prospective observational study included patients aged ≥ 65 years with multiple trauma admitted to the emergency department between July 1 and August 31, 2024. Frailty was assessed using PRISMA-7 and TSFI. Patients were stratified into frail and non-frail groups and further categorized according to age groups (65-74, 75-84, and ≥ 85 years). Clinical characteristics, trauma severity scores, and outcomes, including 28-day mortality, were compared. Receiver operating characteristic (ROC) analysis was used to evaluate discriminative performance, and logistic regression analysis was performed to assess the association between scores and mortality.
resultsA total of 144 patients were included. Frailty was significantly associated with increased 28-day mortality, higher ICU admission rates, and longer hospital stays (p < 0.001). Mortality increased with age, reaching 30.0% in patients aged ≥ 85 years (p = 0.006). Frailty scores (PRISMA-7 and TSFI) increased significantly with age, whereas ISS did not differ significantly across age groups. ROC analysis demonstrated comparable discriminative performance among scoring systems, with PRISMA-7 showing balanced sensitivity and specificity. In logistic regression analysis, all scores were significantly associated with mortality, and frailty identified by PRISMA-7 was associated with a higher mortality risk.
conclusionFrailty is significantly associated with adverse outcomes, including increased mortality, in older trauma patients. Frailty assessment using simple screening tools such as PRISMA-7 may complement traditional trauma severity scores and help identify high-risk patients in emergency settings.
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