Background: Rib fractures are a common injury. Early identification of patients at high risk of poor outcomes offers an opportunity for early aggressive management and to improve outcomes. Many studies analyse risk factors and the development of clinical prediction tools, but no method of early identification has been widely validated. Aim: To determine if mortality or morbidity in rib fracture patients can be predicted by assessment of frailty, sarcopenia or biochemical markers (troponin or brain natriuretic peptide (BNP)); and to assess for ethnic disparities in outcomes, risk factors and early management. Methods: A single-centre prospective observational cohort pilot study, assessing and assessing the value of frailty, sarcopenia and easily accessible biochemical markers (troponin and BNP), for predicting outcomes (lower respiratory tract infection (LRTI), hospital length of stay (LOS), critical care admission, discharge disposition and mortality) in patients with rib fractures from blunt chest trauma. Results: BNP was significantly associated with risk of LRTI (OR 4.53, p = 0.049). Presence of sarcopenia was associated with fewer admissions to critical care. Several other markers showed trends towards offering predictive value for our outcome measures, but failed to reach statistical significance in this initial pilot sample cohort. Conclusion: BNP and sarcopenia were found to offer some predictive value in the assessment of patients >45 years with rib fractures. Further analysis of a larger sample size is required to further investigate the predictive value of frailty scores in this setting.