Effect of Frailty on Hospital Length of Stay and Discharge Outcomes among Geriatric Trauma Patients: A Prospective Observational Study

Objectives: Frailty in older adults is associated with more comorbid conditions, higher mortality, increased falls, and adverse discharge outcomes after hospitalization. While the clinical frailty scale (CFS) and, more recently, the trauma-specific frailty index (TSFI) have been used to study adverse discharge outcomes, few studies have assessed their ability to predict hospital length of stay (LOS) in geriatric trauma patients. The objective of our study was to investigate the impact of frailty on hospital LOS and adverse discharge outcomes among elderly trauma patients. Material and Methods: A prospective observational study was conducted at a single center among geriatric trauma patients aged ≥65 years who were admitted for surgical interventions. Frailty was assessed using the CFS, and patients were categorized into two groups based on CFS scores of 1 -3 and 4 -7 for outcome analysis. The primary outcome was the effect of frailty on LOS. The secondary outcomes were the association of frailty with adverse discharge outcomes, i.e., mortality and correlation of CFS with TSFI. Results: Among 187 geriatric trauma patients, the median age was 74 years, and 53% were female. Frail patients (CFS 4–7) were significantly older than pre-frail patients (CFS 1–3) (76.08 vs. 71.55 years; p = 0.001). TSFI was markedly higher in frail patients (0.20 vs. 0.07; p < 0.001) and positively correlated with CFS ( r = 0.53). No significant differences were found in the LOS, discharge disposition, complications, or 28-day mortality (5% frail vs. 0% pre-frail). Conclusion: Frailty assessed using the CFS was not associated with prolonged LOS or adverse discharge outcomes. Although the TSFI was not associated with LOS, it showed a positive correlation with CFS scores.