Objective: Trauma-related emergency department (ED) admissions among older adults are increasing with population aging. The oldest-old, defined as patients aged ≥85 years, are particularly vulnerable, as even low-energy mechanisms may result in clinically important morbidity and mortality. This study aimed to evaluate the epi-demiological, clinical, and prognostic features of trauma presentations among the oldest-old and to identify factors associated with ED outcomes and 30-day mortality.
Material and Methods: This single-center retrospective observational study included trauma patients aged ≥85 years who presented to the ED between May 1, 2020, and August 1, 2023. Demographic characteristics, mechanisms of injury, frailty levels, clinical and laboratory parameters, injury severity scores, ED outcomes, and 30-day mortality were recorded. Frailty was assessed using the Clinical Frailty Scale. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of 30-day mortality.
Results: A total of 467 patients were included. The median age was 88 years, and 70.2% were female. Falls were the predominant mechanism of injury (91.9%). Overall, 47.8% were discharged, 48.8% were admitted to hospital wards, 2.8% required ICU admission, and 0.6% died in the ED. The 30-day mortality rate was 8.1%. In multivariate logistic regression analysis, the shock index, Geriatric Trauma Outcome Score, and frailty level were identified as independent predictors of 30-day mortality.
Conclusion: Trauma among the oldest-old was predominantly related to low-energy mechanisms, particularly falls, yet was associated with clinically important morbid-ity and mortality. Injury severity scoring, early physiological assessment, and frailty evaluation may improve ED risk stratification. Further prospective studies are required to validate these findings.
Keywords: Emergency; frailty; geriatrics; oldest old; trauma
, Burak Kafalı1 
