The Subdural Hematoma in the Elderly (SHE) score was developed as a model to predict 30-day mortality from acute, chronic, and mixed subdural hematoma in the elderly population after minor or no trauma. Emerging evidence suggests frailty to be predictive of mortality and morbidity in the elderly. In this study, we aim to externally validate the SHE for chronic subdural hematoma (CSDH) alone, and we hypothesize that the incorporation of frailty into the SHE may increase its predictive power. A retrospective cohort of elderly patients with CSDH after minor or no trauma being treated at our institution was evaluated with the SHE. Thirty-day mortality and outcome were documented. Patients were assessed with the Clinical Frailty Scale (CFS), which was incorporated into a modified SHE (mSHE). Both the SHE and the mSHE were then assessed in their predictive powers through receiver operating characteristic statistics. We included 168 patients. Most (n = 124, 74%) had a favorable outcome at 30 days. Mortality was low at n = 7, 4%. The SHE failed to predict mortality (AUC = .564, p = .565). Contrarily, the mSHE performed well in both mortality (AUC = .749, p = .026) and outcome (AUC = .862, p < .001). A threshold of mSHE = 3 is predictive of mortality with a sensitivity of 50% and a specificity of 75% and of poor outcome with a sensitivity of 88% and a specificity of 64%. Frailty should be routinely evaluated in elderly individuals, as it can predict outcome and mortality, providing the possibility for medical, surgical, nutritional, cognitive, and physical exercise interventions.

老年人硬膜下血肿 (SHE) 评分被开发为一个模型，用于预测老年人在轻微或无创伤后急性、慢性和混合性硬膜下血肿的 30 天死亡率。新出现的证据表明，体弱可以预测老年人的死亡率和发病率。在这项研究中，我们旨在外部验证 SHE 单独用于慢性硬膜下血肿 (CSDH)，我们假设将脆弱性纳入 SHE 可能会增加其预测能力。使用 SHE 评估了在我们机构接受轻微或无创伤治疗的老年 CSDH 患者的回顾性队列。记录了 30 天的死亡率和结果。患者使用临床虚弱量表 (CFS) 进行评估，该量表被纳入改良的 SHE (mSHE)。然后通过接收者操作特征统计评估 SHE 和 mSHE 的预测能力。我们纳入了 168 名患者。大多数（n = 124, 74%）在 30 天时结果良好。n = 7, 4% 时死亡率很低。SHE 未能预测死亡率（AUC = .564，p = .565）。相反，mSHE 在死亡率 (AUC = .749, p = .026) 和结果 (AUC = .862, p < .001) 方面表现良好。mSHE = 3 的阈值以 50% 的敏感性和 75% 的特异性预测死亡率，以 88% 的敏感性和 64% 的特异性预测不良结果。应该对老年人进行常规评估，因为它可以预测结果和死亡率，为医疗、手术、营养、认知和体育锻炼干预提供了可能性。