Association Between the Modified Frailty Index-5 and Clinical Outcomes in Burn Patients

Frailty is a clinical state characterized by increased vulnerability to stressors, leading to an increased risk of adverse health outcomes. The modified Frailty Index (mFI-5), based on five comorbidities-diabetes mellitus, heart failure, pulmonary disease, hypertension, and totally or partially dependent functional health status -has shown predictive value for treatment outcomes and mortality. The primary objective of this study was to evaluate differences in clinical outcomes between burn patients with mFI-5 scores of 0, 1, and ≥2. The secondary objective was to determine whether the mFI-5 score independently predicts adverse outcomes. A retrospective analysis of 644 burn patients treated between September 2018 and May 2022 was conducted. Data on comorbidities, complications, ventilation status, surgical procedures, length of stay, and discharge destination were analyzed. Statistical analyses included Pearson's chi-square test, Kruskal-Wallis test, and adjusted multivariate regression analysis. Higher mFI-5 scores were associated with worse overall outcomes, including longer hospital stay, higher rates of complications, more frequent need for mechanical ventilation, a greater number of skin grafts and necrectomies, and more frequent discharge to non-home settings. Multivariate analyses showed that a higher mFI-5 score compared to mFI-5=0 was independently associated with higher rates of urinary tract infections (mFI-5≥2: OR 2,41, 95% CI: 1.19-4.86, p=0.014) and non-home discharge (mFI-5=1: OR 2.34, 95% CI: 1.00-5.45, p=0.049). The mFI-5 is a strong predictor of complications and adverse outcomes in burn patients. Its quick, simple application makes it a valuable risk stratification tool in specialized burn centers.