Controlling Nutritional (CONUT) score and ulcer healing

NewsBot · Jan 11, 2020

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The Controlling Nutritional (CONUT) score is significantly associated with complete ulcer healing in patients with critical limb ischemia.
Furuyama T et al
Ann Vasc Surg. 2020 Jan 6

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.
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