- STUMBL score independently predicts increased 3-month mortality and geriatric-relevant morbidity, including delirium, longer hospital stay, and failure to return to usual residence.
- A STUMBL score greater than 15 shows high sensitivity but low specificity for screening delirium and predicting failure to return home.
- Use STUMBL alongside frailty and cognitive assessment to guide early risk stratification, care planning, and timely geriatric specialist involvement.
Injury. 2026 Aug 19:113601. doi: 10.1016/j.injury.2026.113601. Online ahead of print.
ABSTRACT
INTRODUCTION: Rib fractures are the most common injury following blunt chest trauma, with around 10% of patients requiring hospital admission. The STUMBL (STUdy of the Management of BLunt chest trauma) score was developed to guide admission decisions, but its ability to predict mortality and geriatric-relevant outcomes in older adults is unclear. We evaluated whether the STUMBL score stratifies risk for mortality, delirium, and discharge destination in adults aged ≥ 65 years.
METHODS: We conducted a retrospective single-centre cohort study of patients aged ≥ 65 years presenting with traumatic rib fractures to a Level 1 trauma centre between 1 January and 31 December 2022. The primary outcome was 3-month mortality. Secondary outcomes included delirium, 12-month mortality, length of stay, functional decline, and failure to return to usual place of residence. Discrimination was assessed using receiver operating characteristic analysis, and threshold performance was evaluated at a clinically used cut-point (STUMBL >15).
RESULTS: Among 476 patients (mean age 77.8 years [SD 10.3]; median Clinical Frailty Scale 3 IQR [2-5]), the mean STUMBL score was 24.1 (SD 12.3). Higher STUMBL scores were independently associated with 3-month mortality (OR 1.03, 95% CI 1.01-1.05), delirium (OR 1.04, 95% CI 1.02-1.06), failure to return to usual place of residence (OR 1.05, 95% CI 1.03-1.07), and longer length of stay (all p < 0.01). A STUMBL score > 15 demonstrated high sensitivity but low specificity as a screening threshold for delirium and not returning to usual place of residence on discharge.
CONCLUSION: The STUMBL score is associated with mortality and geriatric-relevant morbidity in older adults with rib fractures. In conjunction with assessment of frailty and cognition, it may support early risk stratification and care planning, including timely geriatric specialist involvement.
PMID:42629302 | DOI:10.1016/j.injury.2026.113601
Share Evidence Blueprint
Save to Google Notes
Search Google Scholar
Save as PDF
⭐ My Revision List
