Frailty Is Associated With Mortality in Patients Aged 50 Years and Older

Recent evidence indicates that increased frailty is associated with increased mortality in patients with burn over the age of 65 years. However, the effect of frailty may not be restricted to those over the age of 65 years. We hypothesize that admission frailty is associated with mortality in patients with burn ≥50 years of age. We performed a 5-year (2008-2013) retrospective review of patients with acute burn aged 50 years or older. Data collected included demographics, injury characteristics, outcomes, and discharge disposition. Frailty scores (FS) were calculated using the Canadian Study of Health and Aging Clinical Frailty Scale. Values are expressed as mean ± SD. About 502 patients with a mean age of 63.5 ± 10.7 years were ansalyzed. Mean TBSA was 11.7 ± 14.1%, 47 patients (9.4%) died, and mean FS was 3.7 ± 1.2 (7 being worst and 1 best). Multivariate logistic regression demonstrated an independent association between mortality and FS of ≥5 (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.3 to 2.8). Patients who were ≥65-years-old had significantly higher FS (4.2 ± 1.2 vs 3.5 ± 1.1), and more deaths (26 vs 21 patients). Multivariate logistic regression revealed that increased admission FS is associated with increased mortality to a greater extent in the 50- to 65-year-old group (age 50-65 years: OR, 2.5; 95% CI, 1.4 to 4.6; age ≥ 65 years: OR, 1.63; 95% CI, 1.003 to 2.7). FS on admission allow for an improved assessment of preinjury physiological condition in patients with burn aged ≥50 years. Poor preinjury physiological fitness is associated with increased risk of death in patients with burn aged ≥50 years.