Frailty Amongst Older Adults Presenting with Traumatic Brain Injuries

Abstract Background Frailty is recognised as a predictor of poor outcomes following trauma, including traumatic brain injuries (TBI). Despite this, frailty assessment is not always integrated into acute trauma pathways. This study evaluates the prevalence of frailty and its association with clinical outcomes in older patients admitted with TBI during the first year of a Geriatric Trauma Service at a National Trauma Centre without on-site neurosurgical capabilities. Methods A retrospective review was conducted of patients aged ≥65 admitted with TBI over a 14-month period. Frailty was assessed using the Clinical Frailty Scale (CFS) when recorded during initial evaluation as part of assessment by the Frailty Intervention Team (FIT) in the Emergency Department. Outcomes included 30-day mortality and length of stay (LOS). Minitab was used for statistical analysis. Results Of 107 patients over 65 admitted with TBI, 42% (n=45) had a documented CFS. The mean age was 82 years, and 58% (n=26) were male. The mean CFS was 4.8 (median: 5), with 58% (n=26) classified as frail (CFS ≥5). Higher frailty scores were associated with 30-day mortality (OR 2.4; 95% CI 0.94–6.16; p=0.06). No difference in LOS was observed between frail and non-frail groups, with a median LOS of 6.5 in the non-frail group, and 6 days in the frail group. Conclusion Frailty is common among older patients with TBI and may be associated with increased mortality. These findings underscore the importance of early frailty identification and the integration of geriatric expertise in trauma care.