Turkish Journal of
GERIATRICS

¹Burdur State Hospital, Department of Thoracic Surgery, Burdur, Turkiye
²Burdur State Hospital, Department of Intensive Care, Burdur, Turkiye DOI : 10.29400/tjgeri.2026.486 Introduction: Tracheostomy is commonly performed in elderly intensive care unit patients requiring prolonged ventilatory support to facilitate airway management, ventilator weaning, secretion control, and patient comfort. Because these patients often have prolonged critical illness, comorbidity burden, and reduced physiological reserve, accurate prognostic assessment is important for clinical management and family counseling. This study evaluated the prognostic value of the Modified Frailty Index-5, disease severity scores, albumin, and lactate in elderly patients undergoing tracheostomy. Materials and Method: Patients aged ?65 years who underwent elective percutaneous tracheostomy for prolonged mechanical ventilation in a general adult intensive care unit between 2021 and 2025 were retrospectively analyzed. Demographic data, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Modified Frailty Index-5, and pre-procedural albumin and lactate concentrations were recorded. The outcomes were 28-day mortality and post-procedural complications. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed. Results: A total of 114 patients were analyzed. Twenty-eight-day mortality was 58.8% and post-procedural complications occurred in 13.2% of patients. Non-survivors had significantly higher Modified Frailty Index-5 and SOFA scores and higher lactate concentrations, while albumin concentrations were lower. In multivariable analysis, the Modified Frailty Index-5 score independently predicted mortality and post-procedural complications. Both the SOFA score and serum lactate concentration emerged as independent predictors of mortality. Conclusion: Frailty assessed by the Modified Frailty Index-5 predicts mortality and post-procedural complications in elderly intensive care unit patients undergoing tracheostomy and may improve clinical risk stratification when integrated with conventional severity scores and pre-procedural lactate and albumin concentrations. Keywords : Tracheostomy; Frailty; Intensive Care Units; Aged; Mortality