title: Validating trauma-specific frailty index for geriatric trauma patients: a prospective analysis.
abstract: BACKGROUND
  The Frailty Index has been shown to predict discharge disposition in geriatric patients. The aim of this study was to validate the modified 15-variable Trauma-Specific Frailty Index (TSFI) to predict discharge disposition in geriatric trauma patients. We hypothesized that TSFI can predict discharge disposition in geriatric trauma patients.
  
  
  METHODS
  We performed a 2-year (2011-2013) prospective analysis of all geriatric trauma patients presenting to our Level I trauma center. Patient discharge disposition was dichotomized into unfavorable (discharge to skilled nursing facility or death) and favorable (discharge to home or rehabilitation center) discharge disposition. Patients were evaluated using the developed 15-variable TSFI. Multivariate logistic regression was performed to identify factors that predict unfavorable discharge disposition.
  
  
  RESULTS
  A total of 200 patients were enrolled for validation of TSFI. Mean age was 77 ± 12.1 years, median Injury Severity Score was 15 (interquartile range [IQR] 9 to 20), median Glasgow Coma Scale score was 14 (IQR 13 to 15), and median Frailty Index score was 0.20 (IQR 0.17 to 0.28); 29.5% (n = 59) patients had unfavorable discharge. After adjusting for age, sex, Injury Severity Score, Head Abbreviated Injury Scale, and vitals on admission, Frailty Index (odds ratio = 1.5; 95% CI, 1.1-2.5) was the only significant predictor for unfavorable discharge disposition. Age (odds ratio = 1.2; 95% CI, 0.9-3.1; p = 0.2) was not predictive of unfavorable discharge disposition.
  
  
  CONCLUSIONS
  The 15-variable TSFI is an independent predictor of unfavorable discharge disposition in geriatric trauma patients. The Trauma-Specific Frailty Index is an effective tool that can aid clinicians in planning discharge disposition of geriatric trauma patients.
  
  
  METHODS
  II Prognostic Studies-Investigating the Effect of a Patient Characteristic on the Outcome of Disease.
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ. Electronic address: bjoseph@surgery.arizona.edu.
authors: Bellal
authors: B
authors: Joseph
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Viraj
authors: V
authors: Pandit
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Bardiya
authors: B
authors: Zangbar
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Narong
authors: N
authors: Kulvatunyou
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Andrew
authors: A
authors: Tang
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Terence
authors: T
authors: O'Keeffe
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Donald J
authors: DJ
authors: Green
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Gary
authors: G
authors: Vercruysse
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Mindy J
authors: MJ
authors: Fain
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Randall S
authors: RS
authors: Friese
authors: Department of Surgery, Division of Trauma, Critical Care, Burns, and Acute Care Surgery, University of Arizona Medical Center, Tuscon, AZ.
authors: Peter
authors: P
authors: Rhee
mesh_terms: D015998:Abbreviated Injury Scale; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D005260:Female; D016330:Frail Elderly; D015600:Glasgow Coma Scale; D006305:Health Status Indicators; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010351:Patient Discharge; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D014947:Wounds and Injuries