Relationships of the frailty index and geriatric trauma outcome score with mortality in geriatric trauma patients.

BACKGROUND: We aimed to determine the relationships of the trauma-specific frailty index (TSFI) and the geriatric trauma out-come score (GTOS) with 30-day mortality among geriatric trauma patients aged 65 and older.

METHODS: This prospective observational study included 382 patients aged 65 years and older who were admitted to a training and research hospital due to blunt trauma. Informed consent was obtained from them and/or their relatives. In addition to patients' vital signs, information about chronic diseases and drug use was obtained on admission to the emergency service and the results of labo-ratory examinations, radiological imaging, blood replacements, length of stay in the emergency room and hospital, and mortality were recorded in case forms. Glasgow coma scale, ınjury severity score, GTOS, TSFI, and body mass index (BMI) values were calculated by the researchers. Outcome information was obtained from the patient and/or relatives by phone 30 days later.

RESULTS: When the patients who died and those who survived were compared at the 30th day after trauma, no significant difference was found in terms of BMI or TSFI (p>0.05). It was determined that patients with a GTOS of ≥95 at admission would have higher 30-day mortality (the sensitivity was 76%, and the specificity was 72.27% (p<0.001)). When correlations were evaluated according to mortality, a correlation was found between the presence of two or more comorbid diseases and mortality (p=0.001).

CONCLUSION: We think that a more reliable frailty score can be obtained using these parameters as we have determined that the TSFI as calculated at admission to the emergency department is not sufficient on its own, while the lactate, GTOS, and the length of hospital stay are also effective in mortality. We suggest that it would be appropriate to use the GTOS in long-term follow-up as well as for predictive power for mortality within 24 h.