A multicentre prospective observational study to investigate the prevalence and short-term impact of frailty, multi-morbidity and sarcopenia in chronic limb threatening ischaemia (CLTI) The FraiLTI - (Frailty in chronic Limb Threatening Ischaemia) Study

BackgroundCLTI 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 and assess their ability to perform activities of daily living (ADLs) alongside multiple long term health conditions (MLTC), polypharmacy and clinical outcomes. MethodsFraiLTI was a UK multi-centre, prospective, observational study, evaluating the prevalence of frailty (Rockwood Clinical Frailty score of [&ge;]5), sarcopenia based on low handgrip strength (<27kg for men and <16kg for women). and anaemia in patients admitted to hospital with chronic limb threatening ischaemia (CLTI). Other outcomes included prevalence of polypharmacy ([&ge;]5 medications) and MLTC ([&ge;]2 long-term health conditions). Recruitment took place from October 2021 to October 2022 in six UK centres 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. Results84 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. There was no difference in 90-day amputation-free survival for those living with or without frailty (97.6% vs 94.8%, p=0.78), sarcopenia (100% vs 94.4%, p=0.58), or anaemia (95.1% vs 97.3% vs p=0.45). MLTC were present in 57 (67.9%) patients and 67 (79.8%) patients met the definition of polypharmacy. ConclusionFrailty, sarcopenia and anaemia are highly prevalent in those with CLTI but none of these factors were associated with amputation free survival in this study. This has highlighted that the management of CLTI patients extends beyond revascularisation alone. Article HighlightsO_ST_ABSType of researchC_ST_ABSMulti-centre, prospective, observational study. Key FindingsThe prevalence of frailty (51.8%), anaemia (53.8%), and sarcopenia (33.3%) is high in people with CLTI. Most patients with CLTI had multiple long-term conditions (MLTC) (67.9%) or polypharmacy (79.8%). Take home MessageThis study shows that frailty, sarcopenia and anaemia are highly prevalent in those with CLTI. The management of CLTI patients extends beyond revascularisation alone. Table of contents SummaryThis study shows that frailty, sarcopenia and anaemia are highly prevalent in those with CLTI. The management of CLTI patients extends beyond revascularisation alone.