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Background Elderly trauma now accounts for more than 20% of UK major trauma [1]. Clearly, elderly trauma patients are at increased risk of morbidity and mortality, but outcome can be difficult to predict. Current evidence is limited to correlations between poor outcome and complex, difficult-to-calculate pre-morbid frailty indices [2]. A simple, evidence-based prognostic marker is needed to guide early management. We hypothesised that elderly patients suffering severe injury at home indoors are frailer, and therefore more likely to succumb to their injuries, than those injured outdoors.

‘Silver’ trauma: predicting mortality in elderly major trauma based on place of injury