Mortality prediction in geriatric patients with multiple trauma presenting by ambulance.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.