Abstract:

Objective To compare the predictive value of the Fatigue，Resistance，Ambulation，Illness and Loss of weight（FRAIL），Clinical Frailty Scale（CFS），and Trauma-Specific Frailty Index（TSFI） for adverse outcomes in elderly trauma patients in an emergency department. Methods This prospective cohort study enrolled 259 elderly trauma patients admitted to a tertiary hospital in Suzhou，China（January to June 2025）. Frailty was assessed using FRAIL，CFS，and TSFI. The predictive value of these tools for adverse outcomes in elderly emergency trauma patients was compared using the area under the receiver operating characteristic curve（AUC）. Results Among 248 included patients，75 patients（30.2%） who experienced adverse outcomes were included in an event group，and 173 patients（69.8%） who did not experience adverse outcomes were in a non-event group. Frailty scores differed significantly between groups（P<0.001）. ROC analysis revealed that TSFI（AUC=0.83，sensitivity=0.83，specificity=0.80） showed higher predictive accuracy than FRAIL（AUC=0.74，sensitivity=0.64，specificity=0.78） and CFS（AUC=0.70，sensitivity=0.59，specificity=0.75）. Conclusion TSFI demonstrated superior predictive efficacy for adverse outcomes in elderly trauma patients，making it more suitable for early frailty assessment in Chinese emergency departments.

Key words: Trauma, Aged, Frailty, Scale, Prediction, Emergency Nursing

摘要：

目的 比较衰弱筛查量表（Fatigue，Resistance，Ambulation，Illness，Loss of weight，FRAIL）、临床衰弱量表（Clinical Frailty Scale，CFS）、创伤特异性衰弱指数（Trauma-Specific Frailty Index，TSFI）对急诊老年创伤患者发生不良结局的预测能力。方法 采用前瞻性队列研究设计，选取2025年1—6月在苏州市某三级甲等医院259例急诊老年创伤患者为调查对象，分别使用FRAIL、CFS、TSFI评估衰弱程度，通过计算受试者操作特征曲线下面积（area under the curve，AUC），比较3种评估工具对急诊老年创伤患者发生不良结局的预测价值。结果 共纳入248例，75例（30.2%）发生不良结局纳入事件组，173例（69.8%）未发生不良结局纳入非事件组，两组间衰弱评分差异具有统计学意义（P<0.001）。FRAIL的AUC为0.74，敏感度和特异度分别为0.64、0.78；CFS的AUC为0.70，敏感度和特异度分别为0.59、0.75；TSFI的AUC为0.83，敏感度和特异度分别为0.83、0.80。结论 TSFI相较FRAIL和CFS在预测急诊老年创伤患者不良结局方面效能较好，更适合国内急诊入院老年创伤患者的早期衰弱评估。

关键词: 创伤, 老年人, 衰弱, 量表, 预测, 急救护理