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Updated: Sep 28, 2025

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

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

Chanean Ruangsetakit1, Sanit Navikaputra1, Kanin Pruekprasert1

  • 1Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Asian Journal of Surgery
|April 2, 2022
PubMed

Insights

The Geriatric Nutritional Risk Index (GNRI) independently predicts amputation risk in Thai patients with chronic limb-threatening ischemia (CLTI) undergoing infrapopliteal angioplasty. The Critical Limb Ischemia Frailty Index (CLIFI) did not significantly predict outcomes in this study.

Area of Science:

  • Vascular Surgery
  • Geriatric Medicine
  • Clinical Outcomes Research

Background:

  • Chronic limb-threatening ischemia (CLTI) poses a significant risk of amputation.
  • Frailty assessment tools are crucial for predicting outcomes in CLTI patients.
  • The Critical Limb Ischemia Frailty Index (CLIFI) combines nutritional status, muscle mass, and mobility to assess frailty.

Purpose of the Study:

  • To validate the CLIFI in Thai patients undergoing infrapopliteal endovascular treatment for CLTI.
  • To identify independent predictors of 2-year amputation-free survival (AFS) in this population.

Main Methods:

  • Retrospective analysis of 266 CLTI patients treated with infrapopliteal angioplasty (June 2014 - February 2017).
  • CLIFI positivity defined by GNRI < 89.8, low skeletal muscle mass index, and/or non-ambulatory status.
  • Kaplan-Meier analysis and Cox proportional hazards models assessed 2-year AFS and predictor associations.

Main Results:

  • Forty patients (15.0%) were CLIFI positive; 226 (85.0%) were CLIFI negative.
  • 2-year AFS rates were 90.3% (CLIFI positive) and 86.6% (CLIFI negative) (p=0.59).
  • Multivariate analysis identified GNRI as an independent predictor of amputation (aHR: 4.87, p=0.02).

Conclusions:

  • The CLIFI was not a significant predictor of 2-year amputation in this Thai CLTI cohort.
  • GNRI emerged as a significant independent predictor of 2-year amputation risk following infrapopliteal angioplasty.
  • These findings highlight the importance of nutritional status in predicting outcomes for CLTI patients.
Abstract

Keywords:
AmputationAngioplastyChronic limb-threatening ischemiaFrailtyNutrition

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