Abstract
Introduction: Frailty assessment in the Emergency Department (ED) may provide prognostic information beyond triage, but the value of the Triage Frailty and Comorbidity Tool (TFC) in older patients admitted to geriatric wards is uncertain. Methods: This retrospective study included patients aged ≥75 years admitted directly from the ED to Merano Hospital Geriatric Ward between May and September 2025. The primary outcome was 90-day mortality; in-hospital mortality was secondary. Analyses included logistic regression, AUROC estimation, predefined TFC ≥ 10% threshold performance, and Kaplan–Meier curves. Results: A total of 225 patients were included. Median age was 86 years (IQR 82–90), median length of stay was 9 days (IQR 6–13), 90-day mortality was 27.6% (62/225), and in-hospital mortality was 11.5% (26/225). Patients who died within 90 days had higher TFC values than survivors [49.5 (31.4–72.3) vs. 19.4 (6.5–43.8); p < 0.001]. Each 10-point increase in TFC was associated with higher odds of 90-day mortality (OR 1.43, 95% CI 1.26–1.63; p < 0.001) and in-hospital mortality (OR 1.38, 95% CI 1.18–1.62; p < 0.001). The AUROC was 0.747 for 90-day mortality and 0.732 for in-hospital mortality. TFC ≥ 10% identified 54/62 deaths, with a sensitivity of 87.1% and NPV of 87.9%. Survival was lower in patients with TFC ≥ 10% (log-rank p = 0.001). Conclusions: The TFC showed prognostic value in older patients admitted from the ED to geriatric care. Although discrimination was moderate, the TFC may support risk stratification during ED-to-ward transition.