Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment

Background: Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral artery disease. Therefore, a multidisciplinary approach is necessary to avoid major amputation in CLTI patients. Malnutrition worsens the condition of CLTI patients, and therefore, it may be important to ev...

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Autores principales:	Kaori Mine, Makoto Sugihara, Takafumi Fujita, Yuta Kato, Koki Gondo, Tadaaki Arimura, Yosuke Takamiya, Yuhei Shiga, Takashi Kuwano, Shin-ichiro Miura
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chronic limb-threatening ischemia controlling nutritional status clinical frailty delayed wound healing Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/d1c35ef77eb144dd9b299f589d23cb0a
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spelling	oai:doaj.org-article:d1c35ef77eb144dd9b299f589d23cb0a2021-11-25T18:33:21ZImpact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment10.3390/nu131137102072-6643https://doaj.org/article/d1c35ef77eb144dd9b299f589d23cb0a2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/3710https://doaj.org/toc/2072-6643Background: Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral artery disease. Therefore, a multidisciplinary approach is necessary to avoid major amputation in CLTI patients. Malnutrition worsens the condition of CLTI patients, and therefore, it may be important to evaluate the nutritional status in patients with CLTI. This study was designed to evaluate the baseline patient characteristics and the influence of the controlling nutritional status (CONUT) score on the clinical results. Method and Results: A retrospective, single-center, non-randomized study was conducted to evaluate the associations of death, major amputation, and wound healing rate at 12 months with the CONUT score on admission. Consecutive CLTI patients (mean age 73.2 ± 10.4 years; 84 males) who underwent endovascular therapy (EVT) for infra-popliteal lesions at Fukuoka University Hospital from January 2014 to May 2019 were enrolled and divided into two groups (higher and lower CONUT score groups). The higher CONUT group showed a higher percentage of dialysis (66.7% vs. 33.9%, <i>p</i> < 0.001) and a higher clinical frailty scale (5.9 ± 1.4 vs. 4.9 ± 1.9, <i>p</i> = 0.005) than the lower CONUT group. Rates of amputation-free survival were 89.5% and 69.8% in the lower and higher CONUT groups, respectively. In addition, rates of wound healing at 12 months were 98.0% and 78.3% in the lower and higher CONUT groups, respectively. Multivariate regression analysis demonstrated that a higher CONUT score was an independent predictor for delayed wound healing (OR: 11.2; 95% CI: 1.29–97.5; <i>p</i> = 0.028). Conclusion: An assessment of the nutritional status using the CONUT score could be useful for predicting wound healing, and earlier nutritional intervention may improve the outcome of CLTI patients. Early examination and treatment, along with raising awareness of the issue, may be important for improving the prognosis.Kaori MineMakoto SugiharaTakafumi FujitaYuta KatoKoki GondoTadaaki ArimuraYosuke TakamiyaYuhei ShigaTakashi KuwanoShin-ichiro MiuraMDPI AGarticlechronic limb-threatening ischemiacontrolling nutritional statusclinical frailtydelayed wound healingNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 3710, p 3710 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic limb-threatening ischemia controlling nutritional status clinical frailty delayed wound healing Nutrition. Foods and food supply TX341-641
spellingShingle	chronic limb-threatening ischemia controlling nutritional status clinical frailty delayed wound healing Nutrition. Foods and food supply TX341-641 Kaori Mine Makoto Sugihara Takafumi Fujita Yuta Kato Koki Gondo Tadaaki Arimura Yosuke Takamiya Yuhei Shiga Takashi Kuwano Shin-ichiro Miura Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment
description	Background: Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral artery disease. Therefore, a multidisciplinary approach is necessary to avoid major amputation in CLTI patients. Malnutrition worsens the condition of CLTI patients, and therefore, it may be important to evaluate the nutritional status in patients with CLTI. This study was designed to evaluate the baseline patient characteristics and the influence of the controlling nutritional status (CONUT) score on the clinical results. Method and Results: A retrospective, single-center, non-randomized study was conducted to evaluate the associations of death, major amputation, and wound healing rate at 12 months with the CONUT score on admission. Consecutive CLTI patients (mean age 73.2 ± 10.4 years; 84 males) who underwent endovascular therapy (EVT) for infra-popliteal lesions at Fukuoka University Hospital from January 2014 to May 2019 were enrolled and divided into two groups (higher and lower CONUT score groups). The higher CONUT group showed a higher percentage of dialysis (66.7% vs. 33.9%, <i>p</i> < 0.001) and a higher clinical frailty scale (5.9 ± 1.4 vs. 4.9 ± 1.9, <i>p</i> = 0.005) than the lower CONUT group. Rates of amputation-free survival were 89.5% and 69.8% in the lower and higher CONUT groups, respectively. In addition, rates of wound healing at 12 months were 98.0% and 78.3% in the lower and higher CONUT groups, respectively. Multivariate regression analysis demonstrated that a higher CONUT score was an independent predictor for delayed wound healing (OR: 11.2; 95% CI: 1.29–97.5; <i>p</i> = 0.028). Conclusion: An assessment of the nutritional status using the CONUT score could be useful for predicting wound healing, and earlier nutritional intervention may improve the outcome of CLTI patients. Early examination and treatment, along with raising awareness of the issue, may be important for improving the prognosis.
format	article
author	Kaori Mine Makoto Sugihara Takafumi Fujita Yuta Kato Koki Gondo Tadaaki Arimura Yosuke Takamiya Yuhei Shiga Takashi Kuwano Shin-ichiro Miura
author_facet	Kaori Mine Makoto Sugihara Takafumi Fujita Yuta Kato Koki Gondo Tadaaki Arimura Yosuke Takamiya Yuhei Shiga Takashi Kuwano Shin-ichiro Miura
author_sort	Kaori Mine
title	Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment
title_short	Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment
title_full	Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment
title_fullStr	Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment
title_full_unstemmed	Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment
title_sort	impact of controlling a nutritional status score on wound healing in patients with chronic limb-threatening ischemia after endovascular treatment
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d1c35ef77eb144dd9b299f589d23cb0a
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Impact of Controlling a Nutritional Status Score on Wound Healing in Patients with Chronic Limb-Threatening Ischemia after Endovascular Treatment

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