What type of study is this?

This is a Meta-Analysis study (also classified as: Systematic Review).

August 25, 2025

Frailty Evaluation for Short-Term Mortality Prediction of Patients With Traumatic Brain Injury: A Meta-Analysis

Key Points

Frailty is linked to increased short-term mortality in traumatic brain injury patients, with an odds ratio of 1.58 suggesting a substantial risk.
Analysis across 15 datasets revealed a significant association, indicating frailty assessment could be crucial in clinical decision-making.
Cohort studies demonstrated stronger mortality risk associations in prospective studies compared to retrospective ones, highlighting study design impact.
Incorporating frailty evaluations may improve risk stratification and ultimately enhance patient care for those suffering from TBI.

Abstract

Objective: Frailty is increasingly recognized as an important prognostic factor in trauma patients. Its role in predicting short-term mortality after traumatic brain injury (TBI), however, remains uncertain. A systematic review and meta-analysis were conducted to evaluate the association between baseline frailty and short-term mortality (within 12 months) in TBI patients. Methods: Cohort studies were identified through PubMed, Embase, and Web of Science up to March 2025. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Fifteen datasets from 14 cohort studies, comprising 1 567 950 patients, were included. Frailty was significantly associated with increased short-term mortality (OR, 1.58; 95% CI, 1.30-1.93; P < .001; I 2 = 93%). Sensitivity analyses showed consistent findings (OR range: 1.48-1.66). Subgroup analyses revealed stronger associations in prospective versus retrospective studies (OR, 3.27 vs 1.41; P < .001), and in studies involving general TBI populations compared to those focusing on subdural hematoma or intracranial hemorrhage (OR, 2.03 vs 1.19; P < .001). The association remained consistent across age groups and sex distribution. Although numerically stronger in studies using non-modified frailty index (OR 2.00 vs 1.31), the difference was not statistically significant ( P = .05). The association was most pronounced at 6-month follow-up compared to 1 month or during hospitalization and was attenuated in studies using multivariate rather than univariate analyses ( P < .001). Conclusions: Frailty may be independently associated with short-term mortality in patients with TBI. Incorporating frailty assessment may enhance risk stratification and support clinical decision-making.

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