Development of the Burn Frailty Index: A prognostication index for elderly patients sustaining burn injuries

Daniel Maxwell, Peter M Rhee, Mack Drake, Juvonda Hodge, Walter Ingram, Rachael Williams

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Frailty has demonstrated enhanced prognostic ability for elderly patient morbidity. The aim was to create a burn-specific frailty index for elderly patients and compare it to commonly used scoring systems in burn management. Methods: From 2013 to 2017, we prospectively surveyed a randomized cohort of patients ≥65-years-old previously admitted to our burn unit. Prognostic comparisons with 6 commonly used indices and multivariate risk analyses were performed. Results: Of 100 included patients, n = 32 were classified as frail. The mean patient age was 73.0 ± 6.8-years with a median follow up of 20.9 months. There were 13 moralities in total, 12 occurred in the frail group including 5 in-house mortalities. Patients classified as frail had significantly more complications (p < 0.001), non-home discharges (p < 0.001), ICU admissions, and longer hospital and ICU lengths of stay (p < 0.001), decreased 1 and 3-year survival (p = 0.001). The BFI was identified as an independent predictor of mortality (p = 0.001) and course-altering diagnoses including sepsis/septic shock, ARDS/ALI, and AKI. Conclusions: The Burn Frailty Index accurately predicts morbidity and mortality in elderly frail patients suffering burn injuries.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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