LAUSR

OBJECTIVE It has been reported that the Controlling Nutritional (CONUT) score, calculated using the serum albumin concentration, total peripheral lymphocyte count, and total cholesterol concentration, is a valuable nutritional status index. In the current study, we assessed whether the CONUT score was a significant predictor of complete ulcer healing in patients with critical limb ischemia (CLI). METHODS In this retrospective, single center, cohort study, conducted from January 2013 to June 2018, we treated 112 limbs of 89 patients with Fontaine 4 CLI at the Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan. The primary end-point of the study was complete ulcer healing after revascularization, and the secondary end-point was amputation-free survival (AFS). RESULTS The mean follow-up time was 17.8 months. Complete ulcer healing was achieved during the follow-up period in 91 (81.2%) limbs. The median ulcer healing time was 104 days (range, 16-574 days). In multivariate analysis, improvement of lower skin perfusion pressure ratio of < 1, end-stage renal disease, and high CONUT score (> 4) were predictive of incomplete ulcer healing in patients with Fontaine 4 CLI. Additionally, the AFS rate was significantly better in patients with a CONUT score ≤ 4 than in those with a CONUT score > 4. CONCLUSION The CONUT score was associated with post-procedure ulcer healing and long-term limbs retention in patients who underwent revascularization. The management of CLI involving ischemic foot ulcers may require ongoing consideration of nutritional status.