Impact of Preoperative Nutrition Status on Wound Healing in Patients With Chronic Limb‐Threatening Ischemia Undergoing Endovascular Therapy

BACKGROUND: In the treatment of chronic limb-threatening Ischemia (CLTI), achieving complete wound healing is a crucial goal. The controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) are objective tools for assessing malnutrition and have been shown to be associated with poor clinical outcomes in patients with CLTI. However, the association between malnutrition, as defined by various tools, and wound healing in patients with CLTI following EVT has not yet been fully evaluated. AIMS: This study aimed to investigate the relationship between malnutrition and wound healing in patients with CLTI undergoing endovascular therapy (EVT). METHODS: A total of 165 patients treated with EVT for CLTI with wounds were retrospectively analyzed for up to 12 months of follow-up between January 2016 and June 2024. The patients were classified into two groups based on their wound healing status 6 months postoperatively: early wound healing group and delayed wound healing group. Nutritional status was evaluated using the CONUT score, GNRI, and PNI. The relationship between nutritional status and delayed wound healing was examined using logistic regression analysis. RESULTS: The delayed wound healing group had significantly higher CONUT score and lower GNRI and PNI. Logistic regression analysis demonstrated that CONUT malnutrition (odds ratio [OR] 4.140, 95% confidence interval [CI] 1.689-10.150, p = 0.002) and GNRI malnutrition (OR 5.269, 95% CI 1.959-14.171, p = 0.001) were independent predictors of delayed wound healing. Receiver operating characteristic (ROC) analysis indicated that the area under the curve (AUC) for the CONUT score (AUC = 0.811) was greater than that for the GNRI (AUC = 0.763), although no significant differences were found (p = 0.324). CONCLUSIONS: Malnutrition is closely associated with delayed wound healing in patients with CLTI following EVT. Nutritional status is crucial for decision-making in the treatment of CLTI, and early nutritional intervention may improve patient outcomes.