Background CLTI is a is a life and limb threatening condition that is associated with a gradual overall decline in health that is under explored. We aim to measure the prevalence of correlated conditions (frailty, sarcopenia and anaemia) in patients with CLTI to assess their ability to perform activities of daily living (ADLs) alongside multimorbidity, polypharmacy and clinical outcomes.

Methods FraiLTI is a multi-centre, prospective, observational study, funded by the National Institute for Health Research (NIHR) and supported by the Vascular and Endovascular Research (VERN). All dedicated vascular centres were eligible to participate. Ethical approval (21/PR/0750) was granted on 13/07/2021. Primary outcome was identification of prevalence rates of frailty, sarcopenia and anaemia. Secondary outcomes included prevalence of polypharmacy and multimorbidity. Analyses included associations between frailty and sarcopenia, with clinical outcomes.

Results By the Rockwood Clinical Frailty Scale, 43 (51.8%) patients were frail. By grip strength, 27 (33.3%) patients were sarcopenic. We found that 43 (53.8%) of patients were anaemic, with an overwhelming majority (92.1%) having normocytic anaemia. Multimorbidity was seen in 57 (67.9%) patients and 67 (79.8%) patients met the definition of polypharmacy. Patients who were frail, were more likely to require a walking aid (p<0.001), be on more medications (p=0.027), have more co-morbidities (p=0.002), more likely to be diabetic (p=0.016), be sarcopenic (p=0.018), fail the walk speed test (p=0.040) and self-report low activity (p<0.001). Patients who were considered sarcopenic by grip strength tended to be older (p=0.031), have more co-morbidities (p=0.049), and were more likely to be anaemic (p=0.004).

Conclusion This study shows that frailty, sarcopenia and anaemia are highly prevalent in those with CLTI. There also appears to be an important interaction between sarcopenia and anaemia, but not frailty and anaemia. The management of CLTI patients extends beyond revascularisation alone.

The authors have declared no competing interest.

https://jvsgbi.com/the-frailti-frailty-in-chronic-limb-threatening-ischaemia-protocol/

This study was funded by the National Institute for Health Research (NIHR), and the Newcastle Hospital Charities.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

London - Hampstead Research Ethics Committee gave ethical approval for this work (21/PR/0750) on 13/07/2021.

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All data produced in the present study are available upon reasonable request to the authors