TY - JOUR
T1 - Development of the Burn Frailty Index
T2 - A prognostication index for elderly patients sustaining burn injuries
AU - Maxwell, Daniel
AU - Rhee, Peter
AU - Drake, Mack
AU - Hodge, Juvonda
AU - Ingram, Walter
AU - Williams, Rachael
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/7
Y1 - 2019/7
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.
AB - 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.
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U2 - 10.1016/j.amjsurg.2018.11.012
DO - 10.1016/j.amjsurg.2018.11.012
M3 - Article
AN - SCOPUS:85057045415
SN - 0002-9610
VL - 218
SP - 87
EP - 94
JO - American journal of surgery
JF - American journal of surgery
IS - 1
ER -