Predictors of Mortality in Geriatric Trauma Patients Admitted in the Intensive Care Unit

Abstract

Geriatric trauma represents a uniquely vulnerable population due to reduced physiological reserve, frailty, and multiple comorbidities. Injury severity based on anatomical scoring has traditionally guided prognostication; however, physiological derangement and organ dysfunction may be more important for the elderly population. This study aimed to evaluate the clinical profile, injury patterns, organ dysfunction, and predictors of mortality in the intensive care unit (ICU) of a level I trauma center. Data for this study were obtained from the ICU trauma registry. All patients more than 65 years old admitted between July 2022 and June 2025 were included. Demographic details, injury characteristics, laboratory parameters, severity scores, hemodynamic status, and organ dysfunction along with ICU outcomes were recorded. Multivariable logistic regression was performed to identify independent predictors of mortality. Patients ( n = 119) with a median age of 73 years were included in our study. ICU mortality rate was 22.7%. Non-survivors had higher injury severity scores (ISS) (14.8 [8.1] vs. 11.3 [5.8]), acute physiology and chronic health evaluation II (31.5 [24.5–37.5] vs. 21[16–24]), and sequential organ failure assessment (SOFA) scores (11 [7.5–12] vs. 6 [3–7]) along with severe metabolic derangements. On multivariable analysis, age ≥85 years (odds ratio [OR] 6.04, 95% confidence interval [CI] 1.02–35.7) and SOFA score (OR 1.91, 95% CI 1.43–2.55) were independently associated with mortality, whereas ISS (OR 1.11, 95% CI 0.99–1.23) showed no significant association. Advanced age (≥85 years) and higher SOFA scores at admission independently associated with mortality, highlighting the dominant role of early organ dysfunction over anatomical injury severity.