title: Geriatric Nutritional Risk Index (GNRI) Independently Predicts Amputation Inchronic Criticallimb Ischemia (CLI).
abstract: OBJECTIVE
  General malnutrition usually occurs in critical limb ischemia (CLI) patients because of shortness of appetite and sleeplessness leaded by chronic pain. And amputation frequently is end-point of CLI patients. So the aim of this study was to assess the predictive ability of Geriatric nutritional risk index (GNRI) for predicting amputation in patients with CLI.
  
  
  METHODS
  A retrospective study was designed. Demographics, history, comorbidity, and risk factors for peripheral vascular disease of admitted patients, and laboratory study were documented. Patients' height, weight and BMI were recorded. Amputation was identified as end-point during follow-up. Patients' amputation-free survival (AFS) was recorded.
  
  
  RESULTS
  172 patients were identified, with mean age 71.98±3.12. Geriatric nutritional risk index (GNRI) = 90 was taken as cutoff value of high risk of amputation for CLI patients via using receiver operating characteristic (ROC) curve. Span of follow-up was 12-48 months. During follow-up, 60 patients (36.04%) received amputation surgery. And analyzed by Cox proportional hazards model, it is found that GNRI was the independent predictive factor for amputation in long term.
  
  
  CONCLUSIONS
  This study revealed that GNRI was a reliable and effective predictive marker for AFS. GNRI could identify patients with high risk for amputation in early time.
authors.affiliation: Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.|Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Han
authors.initials: H
authors.lastname: Luo
authors.affiliation: Department of Nephrology, Biostatistics Center, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Hongliu
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Biostatistics Center, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Ding
authors.initials: D
authors.lastname: Yuan
authors.affiliation: Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jingqiang
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jichun
authors.initials: J
authors.lastname: Zhao
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D005121:Extremities / Q000098:blood supply* / Q000601:surgery; D015577:Geriatric Assessment; D006801:Humans; D008875:Middle Aged; D009752:Nutritional Status; D012189:Retrospective Studies; D018570:Risk Assessment