Home > Journals > International Angiology > Past Issues > Articles online first > International Angiology 2021 Oct 12

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe PROMO
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

 

International Angiology 2021 Oct 12

DOI: 10.23736/S0392-9590.21.04739-8

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Impact of nutritional and inflammatory status in patients with critical limb-threatening ischemia

Elena GARCÍA-RIVERA 1, Enrique M. SAN NORBERTO 1 , Liliana FIDALGO-DOMINGOS 2, Álvaro REVILLA-CALAVIA 1, Isabel ESTÉVEZ-FERNÁNDEZ 1, Noelia CENIZO-REVUELTA 1, Miguel MARTÍN-PEDROSA 1, Carlos VAQUERO-PUERTA 1

1 Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, Spain; 2 Department of Angiology and Vascular Surgery, Centro Hospitalar Universitario do Algarve, Faro, Portugal


PDF


BACKGROUND: A pro-inflammatory state and a poor nutritional status have been associated with severity and prognosis of patients with peripheral arterial disease (PAD). The clinical applicability of the different pre-operative nutritional and inflammatory biomarkers in patients with critical limb-threatening ischemia (CLTI) was analyzed.
METHODS: A retrospective observational study was performed, that included all patients with CLTI revascularized from January 2016 to July 2019. The inflammatory state was calculated using neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR) and platelet/lymphocyte ratios (PLR). For nutritional status, the Prognostic Nutritional Index (PNI) was calculated. Mortality and number of major amputations at 6 months and hospital length-of stay were studied.
RESULTS: 310 patients were included. Higher levels of NLR and lower levels of PNI were associated with mortality (6.61±5.6 vs 3.98±3.27, p=0.034; 40.33±7.89 vs 45.73±7.48, p=0.05, respectively). Lower levels of PNI and LMR (42.57±7.82 vs 45.44±7.65, p=0.036; 2.77±1.61 vs 3.22±1.75, p=0.013, respectively) and higher levels of NLR (6.91±7.85 vs 3.94±2.57, p=0.023) were associated with major amputations. The mean hospital length-of-stay was higher in patients with lower levels of PNI and LMR (p=0.000 and p=0.003) and higher levels of NLR and PLR (p=0.001 and p=0.002). A PNI<42.87 predicted short-term mortality with a 66.7% of sensitivity and a 66.8% of specificity (p=0.000).
CONCLUSIONS: Our experience suggests that these inflammatory and nutritional biomarkers are independent predictors of short-term mortality and major amputations. In addition, our results suggest that PNI could be used to predict the short-term mortality with high sensitivity and specificity.


KEY WORDS: Peripheral arterial disease; Critical limb ischemia; Biomarkers; Prognostic nutritional index; Serum albumin; Mortality rate

top of page