Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug;31(8):739-746.
doi: 10.14744/tjtes.2025.42574.

Mortality prediction in geriatric patients with multiple trauma presenting by ambulance

Aynur Yurtseven  1 , Afşin Emre Kayıpmaz  1
Affiliations

Mortality prediction in geriatric patients with multiple trauma presenting by ambulance

Aynur Yurtseven et al. Ulus Travma Acil Cerrahi Derg. 2025 Aug.

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.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Area under the curve (AUC) for mortality prediction according to scoring systems.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Murphy SL, Kochanek KD, Xu J, Arias E. Mortality in the United States, 2023. NCHS Data Brief. 2024;521:CS356116. - PMC - PubMed
    1. Panossian VS, Lagazzi E, Rafaqat W, Abiad M, Nzenwa IC, Arnold S, et al. Outcomes of severe isolated blunt chest trauma in young and geriatric patients. Eur J Trauma Emerg Surg. 2024;50:2471–80. - PubMed
    1. Elliott A, Taub N, Banerjee J, Aijaz F, Jones W, Teece L, et al. Does the clinical frailty scale at triage predict outcomes from emergency care for older people? Ann Emerg Med. 2021;77:620–7. - PubMed
    1. Maxwell C A, Mion L. C, Mukherjee K, Dietrich M. S, Minnick A. F, May A. K, et al. Development of a geriatric trauma outcome score. Journal of Trauma and Acute Care Surgery. 2012;72((6)):1649–1655.
    1. Bergeron E, Lavoie A, Clas D, Moore L, Ratte S, Tetreault S, et al. Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. J Trauma. 2003;54:478–85. - PubMed

LinkOut - more resources