The Burn Frailty Index (BFI) identifies an elderly burn patient at increased risk for mortality. The index is modified from the Emergency General Surgery Frailty Index (EGSFI). The authors are from Emory University, East Carolina University and the Grossman Burn Center (Wewst Hills, California).
Patient selection: burn patient >= 65 years of age
Parameters:
(1) cancer history
(2) diabetes
(3) needs help with grooming
(4) needs help with managing money
(5) needs help doing household work
(6) feels sexually active
(7) coronary artery disease
(8) dementia
(9) needs help walking
(10) feels sad
(11) feels lonely
(12) Glasgow coma scale on admission
(13) serum albumin concentration on admission in g/dL
(14) serum creatinine concentration on admission in mg/dL
(15) total burn surface area (TBSA) on admission in percent
|
Parameter |
Finding |
Points |
|
cancer history |
no |
0 |
|
|
yes |
1 |
|
diabetes |
no |
0 |
|
|
yes |
1 |
|
needs help with grooming |
no |
0 |
|
|
yes |
1 |
|
needs help with money |
no |
0 |
|
|
yes |
1 |
|
needs help with housework |
no |
0 |
|
|
yes |
1 |
|
feels sexually active |
no |
0 |
|
|
yes |
1 |
|
coronary artery disease |
no |
0 |
|
|
medication |
0.25 |
|
|
PCI |
0.5 |
|
|
CABG |
0.75 |
|
|
AMI |
1 |
|
dementia |
none |
0 |
|
|
mild |
0.25 |
|
|
moderate |
0.5 |
|
|
severe |
1 |
|
needs help with walking |
no |
0 |
|
|
cane |
0.25 |
|
|
walker |
0.75 |
|
|
wheelchair |
1 |
|
feels sad |
rarely |
0 |
|
|
sometimes |
0.5 |
|
|
most of the time |
1 |
|
feels lonely |
rarely |
0 |
|
|
sometimes |
0.5 |
|
|
most of the time |
1 |
|
Glasgow coma scale |
14 or 15 |
0 |
|
|
3 to 13 |
1 |
|
serum albumin |
>= 3 .0 g/dL |
0 |
|
|
< 3.0 g/dL |
1 |
|
serum creatinine |
< 1.0 mg/dL |
0 |
|
|
1.0 to 1.49 mg/dL |
1 |
|
|
1.5 to 1.99 mg/dL |
1.5 |
|
|
>= 2.0 mg/dL |
2 |
|
TBSA |
< 5% |
0 |
|
|
5 to 9.9% |
0.25 |
|
|
10 to 14.9% |
1 |
|
|
15 to 19.9% |
1.5 |
|
|
20 to 24.9% |
1.75 |
|
|
>= 25% |
2 |
wheree:
• The item "feels sexually active" seems out of place.
total score =
= SUM(points for all of the parameters)
BFI =
= (total score) / 15
Interpretation:
• minimum score: 0
• maximum score: 17
• minimum BFI: 0
• maximum BFI: 1.13
• An index >= 0.30 indicates frailty.
Performance:
• The area under the ROC curve was 0.91.
Specialty: Emergency Medicine
