The study analyzed 426 geriatric patients hospitalized in otolaryngology departments of eight university hospitals to identify factors predicting adverse outcomes, such as prolonged hospitalization, 30-day serious complications, and 90-day decline in functional capacity. The most significant predictors were physical inactivity, dependence on daily functioning and disturbed food intake, while all three factors were significantly related to the observed negative results (p < 0.05). Traditional risk scales, such as the ASA and Caprini, had limited predictive value, while the Charlson comorbidity index provided additional utility. The results emphasize the need to include assessment of functional status, especially mobility and nutrition, in the routine risk stratification of geriatric patients. Such an approach will enable better identification of high-risk patients and support more personalized clinical management. The study points to the practical value of simple functional indicators versus complex risk scales in the care of elderly otorhinolaryngological patients.