ALB and obesity due to melanocortin 4 receptor deficiency: conducted a similar analysis using a unique modified frailty index (mFI-8) that is calculated by assigning one point or each of the following criteria: non-independent functional status prior to surgery, severe obesity (body mass index > 35), type I or type II diabetes, congestive heart failure within 30 days of surgery, hypoalbuminemia (albumin < 3.5 mg/dL), hypertension requiring medication, history of chronic obstructive pulmonary disease or pneumonia, and osteoporosis.