571 Evaluating the Relationship Between BMI and Frailty in Older Adult Burn Patients
Bibliographic record
Abstract
Abstract Introduction Frailty refers to an age-related syndrome of functional and physiological decline that is characterized by heightened vulnerability to adverse health events. Previous literature has demonstrated the efficacy of frailty assessment among burn injured patients. There is a U-shaped association between body mass index (BMI) and frailty with both ends of the BMI spectrum representing higher risk for elevated frailty scores. BMI has previously been shown to have a significant impact on inpatient length of stay, adverse events, and mortality. Despite this, there is a paucity of literature evaluating the complex relationship between frailty and BMI in burn patients. In this study, we investigated the relationship between BMI and frailty scores and their effects on burn outcomes in a multicenter population of older adult burn patients. Methods Burn injured patients admitted to 12 burn centers from January 2017 to December 2019 who were 60 years and older were retrospectively reviewed. Demographics, injury characteristics, and clinical metrics were obtained. Frailty was assigned to patients using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS). BMI was used to stratify patients as underweight (UW; BMI< 18.5), non-obese (NO; BMI 18.5-24.9), overweight (OW; BMI 25-29.9), obese I (OI; BMI 30-34.9), obese II (OII; BMI 35-39.9), or obese III (OIII; BMI≥40). Outcomes evaluated included the number of operations per admission, length of stay (LOS), and in-hospital mortality. Data is presented as mean ± SD. Frailty score by BMI, LOS and mortality were examined by Kruskal-Wallis test. Results Of 1,632 older adult burn patients, 1,415 patients had BMI data and were included for study. Of these, 49 were UW, 413 NO, 475 OW, 278 OI, 105 OII, and 95 OIII. Mean age was 70±8.5 years, mean TBSA burn was 8.4±12.1%, and the mortality rate was 8.8%. Frailty score was higher in UW (4.7±1.1) compared to NW (4.1±1.4; p=0.03), OW (3.8±1.3; p< 0.0001), and OI (3.8±1.2; p=0.0001). Frailty in NW (4.1±1.4) was also higher compared to OW (3.8±1.3; p=0.01) and OI (3.8±1.2; p=0.04). Total operations, LOS, and mortality were not significantly affected by BMI classification. Conclusions Frailty scores were significantly higher in underweight patients compared to normal weight, overweight or obese burn patients. Differences in BMI did not affect the LOS, total operations or mortality. Applicability of Research to Practice Although the relationship of BMI and frailty remain complex, understanding the effect of BMI extremes like being underweight may help with determining frailty status. Funding for the Study N/A
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".