Bradley, N.A. and Walter, A. and Roxburgh, C.S.D. and McMillan, D.C. and Guthrie, G.J.K. (2024) The relationship between clinical frailty score, CT-derived body composition, systemic inflammation, and survival in patients with chronic limb threatening ischaemia. Annals of Vascular Surgery, 104. pp. 18-26. ISSN 0890-5096
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Introduction:
Frailty is a chronic condition with complex aetiology and impaired functional performance, which has been associated altered body composition and chronic inflammation. Chronic Limb Threatening Ischaemia (CLTI) carries significant morbidity and mortality and is associated with poor quality of life. The present study aims to examine these relationships and their prognostic value in patients with CLTI.
Methods:
Consecutive patients presenting as unscheduled admissions to a single tertiary centre with CLTI were included over a 12-month period. Frailty was diagnosed using the clinical frailty scale (CFS). Body composition was assessed using CT at the L3 vertebral level (CT-BC) to generate visceral and subcutaneous fat indices (VFI, SFI), skeletal muscle index (SMI), and skeletal muscle density (SMD). SMI and SMD were combined to form the CT-sarcopenia score (CT-SS). Systemic inflammation was assessed by the modified Glasgow Prognostic Score (mGPS). The primary outcome was overall mortality.
Results:
There were 190 patients included with a median (IQR) follow-up of 22 (6) months (range 15-32 months), and 79 deaths during the follow-up period. 100 patients (53%) had a CFS > 4. CFS > 4 (HR 2.14, 95% CI 1.25 – 3.66, p <0.01), CT-SS (HR 1.47, 95% CI 1.03 – 2.09, p <0.05), and mGPS (HR 1.54, 95% CI 1.11 – 2.13, p <0.01) were independently associated with increased mortality. CT-SS (OR 1.88, 95% CI 1.09 – 3.24, p < 0.01) was independently associated with CFS > 4. Patients with CT-SS 0 & CFS ≤4 had 90% (SE 5%) 1-year survival, compared with 35% (SE 9%) in patients with CT-SS 2 & CFS >4 (p <0.001). Patients with mGPS 0 & CFS ≤ 4 had 94% (SE 4%) 1-year survival compared with 44% (SE 6%) in the mGPS 2 & CFS > 4 subgroup (p <0.001).
Conclusions:
Frailty assessed by CFS was associated with CT-BC. CFS, CT-SS and mGPS were associated with poorer survival in patients presenting as unscheduled admissions with CLTI. CT-SS and mGPS may contribute to part of frailty and prognostic assessment in this patient cohort.
Bradley, N.A.
Author
Bradley, Nicholas A. and Roxburgh, Campbell S.D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) A systematic review of the role of systemic inflammation-based prognostic scores in patients with abdominal aortic aneurysm. Surgeon, 23 (1). e1-e8. ISSN 1479-666X
Bradley, Nicholas A. and Walter, Amy and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell S.D. and Guthrie, Graeme J.K. and McMillan, Donald C. (2025) The relationship between peri-operative systemic inflammation and survival in patients with abdominal aortic aneurysm. Annals of Vascular Surgery, 110 (Part A). pp. 329-339. ISSN 0890-5096
Bradley, Nicholas and Dosanj, Karamonique and Chan, Sharon Yen Ming and Wilson, Alasdair and Siddiqui, Tamim and Forsythe, Rachel and Roxburgh, Campbell S.D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2024) The relationship between CT-derived cervical muscle mass and quality, systemic inflammation, and survival in symptomatic patients undergoing carotid endarterectomy. BJS Open, 8 (5): zrae114. ISSN 2474-9842
See full publications listWalter, A.
Author
Bradley, N.A. and Walter, A. and Roxburgh, C.S.D. and McMillan, D.C. and Guthrie, G.J.K. (2024) The relationship between clinical frailty score, CT-derived body composition, systemic inflammation, and survival in patients with chronic limb threatening ischaemia. Annals of Vascular Surgery, 104. pp. 18-26. ISSN 0890-5096
Bradley, N.A. and Walter, A. and Wilson, A. and Siddiqui, T. and Roxburgh, C.S.D. and McMillan, D.C. and Guthrie, G.J.K. (2023) The relationship between CT-derived body composition, systemic inflammation, and survival in patients with abdominal aortic aneurysm. Journal of Vascular Surgery, 78 (4). 937-944.e4. ISSN 0741-5214
See full publications listRoxburgh, Campbell S. D.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
See full publications listMcMillan, D.C.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
See full publications listGuthrie, G.J.K.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Bradley, Nicholas A. and Walter, Amy and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell S.D. and Guthrie, Graeme J.K. and McMillan, Donald C. (2025) The relationship between peri-operative systemic inflammation and survival in patients with abdominal aortic aneurysm. Annals of Vascular Surgery, 110 (Part A). pp. 329-339. ISSN 0890-5096
Bradley, Nicholas and Dosanj, Karamonique and Chan, Sharon Yen Ming and Wilson, Alasdair and Siddiqui, Tamim and Forsythe, Rachel and Roxburgh, Campbell S.D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2024) The relationship between CT-derived cervical muscle mass and quality, systemic inflammation, and survival in symptomatic patients undergoing carotid endarterectomy. BJS Open, 8 (5): zrae114. ISSN 2474-9842
See full publications listAvailable under License Creative Commons Attribution.
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