Traumatic brain injury (TBI) is a leading cause of mortality and disability among elderly individuals, particularly in low- and middle-income countries where access to advanced neurosurgical care is limited. This study aimed to develop and validate a simplified, pragmatic scoring system for predicting mortality in geriatric TBI patients using routinely available clinical and radiological variables.

A retrospective cohort study was conducted at a tertiary neurosurgical center and included 101 elderly TBI patients. Data were collected on age, Glasgow coma scale, intracranial hemorrhage volume, neurological deficits, seizures, and hypertension. Independent predictors of mortality were identified and incorporated into a simplified scoring model.

Multivariate logistic regression was used to determine independent predictors of mortality. Regression coefficients were used to derive a weighted scoring system. Model performance was evaluated using the area under the receiver operating characteristic curve and the Hosmer–Lemeshow's goodness-of-fit test.

Patients were divided into low- (0–5 points), moderate- (6–10 points), and high-risk (≥11 points) categories. Corresponding mortality rates were 5, 15, and ≥35%, respectively. The scoring model demonstrated good discrimination and calibration for predicting mortality in geriatric TBI patients.

We developed a simple, evidence-based mortality prediction score for elderly TBI patients based on routine clinical and radiological parameters. This tool may facilitate early risk stratification and guide clinical decision-making in resource-constrained acute care settings.

Article published online:
18 March 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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