Ashwin, Sivaharan, Blaise, Hickson, Tamer, El-Sayed, Lauren, Shelmerdine, Sai, Wunnava, Emily, James, Craig, Nesbitt, Alasdair, O’Doherty ORCID: https://orcid.org/0000-0002-9953-9772, Miles, Witham and Sandip, Nandhra (2026) A multicentre prospective observational study to investigate the prevalence and short-term impact of frailty, sarcopenia, anaemia and multiple long term health conditions in chronic limb threatening ischaemia (CLTI) - The FraiLTI (Frailty in Chronic Limb Threatening Ischaemia) Study. Annals of the Royal College of Surgeons of England. (In Press)

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Abstract

Background
Chronic limb-threatening ischaemia (CLTI) is a life and limb-threatening condition that is associated with a gradual overall decline in health which remains under-explored. We explore the prevalence of correlated conditions (frailty, sarcopenia and anaemia) in patients with CLTI, alongside multiple long-term conditions (MLTC), polypharmacy and clinical outcomes.
Methods
FraiLTI was a UK-wide observational study (Oct 2021–Oct 2022) examining frailty (Rockwood Clinical Frailty score ≥5), sarcopenia (handgrip <27kg men, <16kg women), and anaemia in patients with CLTI. The study also reported polypharmacy (≥5 medications) and MLTC (≥2 long-term health conditions. It involved six UK centres, was supported by the Vascular and Endovascular Research Network and funded by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre (BRC) North-East.
Results
84 patients were included in the study (54 [64.3%] men), with a mean (SD) age of 71.5 (11) years. 43/83 (51.8%) patients were living with frailty. 27/81 (33.3%) patients had probable sarcopenia, 43/80 (53.8%) patients had anaemia of which 35 (92.1%) had normocytic anaemia. Ninety-day amputation-free survival did not differ significantly by frailty (97.6% vs 94.8%, p=0.78), sarcopenia (100% vs 94.4%, p=0.58), or anaemia (95.1% vs 97.3%, p=0.45). MLTC were present in 57 (67.9%) patients and 67 (79.8%) patients met the definition of polypharmacy.
Conclusion
Frailty, sarcopenia and anaemia are highly prevalent in those with CLTI but these factors were not found to have a statistically significant association with amputation-free survival in this study. This has highlighted that the management of CLTI patients extends beyond revascularisation alone.

Item Type:	Article
Status:	In Press
Subjects:	Q Science > QP Physiology R Medicine > RD Surgery
School/Department:	School of Health Sciences
Institutes:	Institute for Health and Care Improvement
URI:	https://ray.yorksj.ac.uk/id/eprint/15882

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