Clinical Frailty Score in Major Trauma Patients – data analysis for 2025 North of Scotland Major Trauma Centre

Method 

Patients aged over 65 with moderate (Injury Severity Score ISS > 9) or major trauma (Injury Severity Score ISS >15) admitted to Aberdeen Royal Infirmary, NHS Grampian, had a Clinical Frailty Score (CFS) recorded within their rehabilitation documentation. Scores were assigned by trauma coordinators, Emergency Department clinicians, or the Frailty Team. Data were collated in an MTC patient spreadsheet, and entries from 2025 were extracted and analysed.

Results 

Initial analysis showed 213 patients were on North of Scotland MTC pathway over the 12 month period, 82 were over 65 years old. CFS was recorded for 66 of these patients, 13 deemed not applicable and 3 had no score recorded.

The majority of patients over 65 had low CFS scores and the ISS varied from 9 – 45. Forty nine of these patients were discharge directly home, 13 patients required ongoing in patient stay in the network when fit for discharge.

Conclusions 

The majority of over 65s were not classed as frail on admission to the MTC pathway and the largest number of over 65s are still being discharged home from the acute setting which supports ‘Home first’ policies along with rehabilitation in hospital being part of the patient recovery journey. Strengthening the frailty pathway—through collaboration between MTC coordinators and the Frailty Team—will help ensure consistent assessment and improve rehabilitation access for older and frail trauma patients in hospital and beyond. Further exploration of data is recommended by the MTC team including frailty in relation to age and mortality at 30 days.