Recognising anaemia and malnutrition in vascular patients with critical limb ischaemia

Ann R Coll Surg Engl. 2010 Sep;92(6):495-8. doi: 10.1308/003588410X12664192075738. Epub 2010 May 28.


Introduction: Anaemia is a common problem in surgical patients. Patients with critical limb ischaemia (CLI) suffer chronic inflammation, repeated infection, require intervention, and can have a protracted hospital stay. The aims of this study were to assess anaemia and nutritional status in patients presenting with CLI.

Patients and methods: Two observational studies were undertaken, initially a retrospective series of 27 patients with CLI. Patient demographics, clinical details, transfusion status and in-patient laboratory haemoglobin values (Hb) were recorded. In a prospective series of 32 patients, laboratory markers to identify the cause for anaemia were assessed. Further nutritional status was assessed by records of height, weight, body mass index and a validated scoring system.

Results: In the retrospective series, 15 patients (56%) were anaemic. Ten (37%) were transfused a median of 2 units (range, 2-13), a total of 35 units. Patients who were transfused had lower Hb on admission (P = 0.0019), most were anaemic on admission (90%). At discharge, most patients were anaemic (n = 23; 83%). In the prospective series of 32 patients, 20 (63%) were anaemic. Nutritional assessment was performed on 18, only seven patients were scored undernourished. This was increased to 23 by an independent assessor. Anaemia was associated with malnutrition (n = 17; P = 0.049) and an increased hospital stay (mean 25 days [SD 16] vs mean 12 days [SD 8], P = 0.0125; total 513 vs 144 bed days).

Conclusions: Anaemia and poor nutrition are common and not recognised in vascular patients presenting with critical limb ischaemia. Anaemia is associated with and increased length of hospital stay.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / diagnosis
  • Anemia / etiology*
  • Anemia / therapy
  • Blood Transfusion
  • Epidemiologic Methods
  • Extremities / blood supply*
  • Female
  • Hemoglobins / metabolism
  • Hospitalization
  • Humans
  • Ischemia / complications*
  • Length of Stay / statistics & numerical data
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / etiology*
  • Middle Aged
  • Nutritional Status


  • Hemoglobins