TY - JOUR PY - 2019// TI - Development of the Burn Frailty Index: a prognostication index for elderly patients sustaining burn injuries JO - American journal of surgery A1 - Maxwell, Daniel A1 - Rhee, Peter A1 - Drake, Mack A1 - Hodge, Juvonda A1 - Ingram, Walter A1 - Williams, Rachael SP - 87 EP - 94 VL - 218 IS - 1 N2 - 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.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

LA - en SN - 0002-9610 UR - http://dx.doi.org/10.1016/j.amjsurg.2018.11.012 ID - ref1 ER -