723 - BJS Prize entrant: vascular society sol Cohen prize winner: saving legs—micronutrient deficiencies & Chronic Limb Threatening Ischaemia (CLTI)—provisional results

Abstract Introduction Chronic Limb Threatening Ischaemia (CLTI) carries significant risk of limb loss. Malnutrition & frailty are of significant concern in this group of patients with more than 15% deemed frail by standard malnutrition screening tools. We want to understand if the presence of micronutrient deficiencies related to malnutrition is impacting limb salvage in patients with CLTI. Methods Patients presenting with a diagnosis of CLTI were recruited. Baseline micronutrient analysis was carried out. Vitamin A,C,D,E, zinc, copper & ferritin were sampled and sent for analysis. Demographics were recorded and nutritional assessments made. Patients were followed up over 12 months and data relating to arterial intervention, amputation, MACE and MALE were collated. Results 70 patients were enrolled. 78.5% (n = 55) were male. The average age at admission was 73. 62.9% (n = 44) were diabetic and 24.3% (n = 17) had a MUST score of 2 or more. 44.3% (n = 31) had a frailty score of > 4. 71.4% (n = 45) were deficient in Vitamin C. 64.4% (n = 45) were low in Zinc. 76.7% (n = 46) were low or deficient in Vitamin D. Major amputation rate to date (mean follow up time 16 months) was 14.2% (n = 10). Mortality rate was 27.1%. Of those deficient in Vitamin C, Zinc or Albumin, odds of death were 3–4 times higher (binary logistic regression). Amputation was not significantly affected by micronutrient deficiency. Conclusions Malnutrition & micronutrient deficiencies should be a concern for clinicians caring for patients with CLTI, particularly those undergoing revascularisation. This preliminary data shows increased mortality rates for patients with micronutrient deficiencies.