The Geriatric Nutritional Risk Index predicts amputation after infrapopliteal angioplasty in critical limb ischemia patients

• Published in: Asian journal of surgery Vol. 46; no. 1; pp. 250 - 253
• Main Authors: Ruangsetakit, Chanean, Navikaputra, Sanit, Pruekprasert, Kanin, Prapassaro, Tossapol, Puangpunngam, Nattawut, Hongku, Kiattisak, Hahtapornsawan, Suteekhanit, Chinsakchai, Khamin, Wongwanit, Chumpol, Sermsathanasawadi, Nuttawut
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.01.2023
• Subjects: Amputation; Angioplasty; Chronic limb-threatening ischemia; Frailty; Nutrition; Frailty; Nutrition; Angioplasty; Amputation; Chronic limb-threatening ischemia
• ISSN: 1015-9584; 0219-3108
• DOI: 10.1016/j.asjsur.2022.03.049

To validate the Critical Limb Ischemia Frailty Index (CLIFI), and to identify independent predictors of 2-year amputation-free survival after infrapopliteal endovascular treatment for chronic limb-threatening ischemia (CLTI) in Thai patients. This retrospective study was conducted during the June 2014 to February 2017 study period. CLTI patients treated with infrapopliteal angioplasty were enrolled and analyzed. A patient was defined as CLIFI positive if two or more of the following criteria were present: Geriatric Nutritional Risk Index (GNRI) < 89.8, low skeletal muscle mass index (<6.87 kg/m2 in males, and <5.46 kg/m2 in females), and/or non-ambulatory status. Kaplan–Meier survival analysis was used to assess 2-year amputation-free survival (AFS), and comparisons were performed using log-rank test. Univariate and multivariate Cox proportional hazards models were used to analyze for significant and independent association, respectively, between preoperative characteristics and AFS. A total of 266 patients and 286 limbs were included. Forty (15.0%) patients were CLIFI positive, and 226 (85.0%) patients were CLIFI negative. The 2-year amputation-free survival rate was 90.3% in the CLIFI positive group, and 86.6% in the CLIFI negative group (p = 0.59). Multivariate analysis revealed the GNRI to be an independent risk factor for amputation within two years after infrapopliteal revascularization (adjusted hazard ratio: 4.87, 95% confidence interval: 1.20–19.70; p = 0.02). The GNRI was found to independently predict 2-year amputation after infrapopliteal angioplasty in Thai CLTI patients; however, the CLIFI was not found to significantly predict 2-year amputation in this patient population.