Evaluation of THE Qualitative and the Quantitative Malnutrition, as a Risk Factor for Large Amputations and Re-amputations in Patients with Critical Limb Ischemia

Abstract

Introduction: Patients with critical limb ischemia are exposed to qualitative and quantitative malnutrition as a result of anorexia caused by chronic pain, insomnia, overuse of analgesics and limitation of mobility. Furthermore, malnutrition is a well-known factor that causes coagulation disorders, immunosuppressions, and directly adversely affects the wound healing process. The aim of this study was to assess the importance of qualitative and quantitative malnutrition in the analysis of the results of revascularization procedures, that is, the frequency as well as the height of amputation, re-mortification, and mortality in patients with critical lower limb ischemia. Methods: The study analyzed the results of laboratory tests: the level of total protein, albumin, hemoglobin, iron, vitamins (A; E and B12) and biometrics (BMI, MNA scale) 200 patients between 50-85 years of age who were admitted to the hospital urgently due to critical lower limb ischemia (grade III and IV on the Fontain scale). All 200 patients were qualified for either surgical revascularization or primary amputation. The results of the analysis of the nutritional status of the patient with the results of surgical treatment are summarized. The endpoint of the study was either primary limb amputation or limb reamputation within 30 days after the first operation. Results: More than 65% of the patients with critical lower limb ischemia had symptoms of quantitative and qualitative malnutrition. Of which more than 45% of patients were extremely undernourished, both qualitatively and quantitatively. Due to severe mental and physical degradation in the group of patients with extreme malnutrition, the primary proportion of large amputations in patients was 33%. In the control group without malnutrition 3% The proportion of secondary large amputations after revascularization procedures in extremely malnourished patients was 15%, while in the control group 1%. Conclusion: Among the surveyed patient population, extreme malnutrition was an important predictor of the loss of the diseased lower limb even after effective revascularization. Disclosure: Nothing to disclose