Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients

Cai, Zhongming; Wu, Yanzhi; Chen, Hao-man; Feng, Renqian; Liao, Cheng-Wei; Ye, Sheng-lie; Liu, Zhipeng; Zhang, Manman; Zhu, Bin

doi:10.1038/s41430-020-0605-8

Cited by 60 publications

(52 citation statements)

References 31 publications

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“…The immune dysfunction and cytokine storm play an important role in the progression of COVID-19 patients [25,26]. In addition, CONUT has been con rmed valuable in assessing nutritional status and hence associated with outcome in various patients [27][28][29]. Malnutrition is actually a potent predictor of mortality in some viral infection such as in uenza A (H1N1) virus infection [30,31].…”

Section: Discussionmentioning

confidence: 99%

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

Wang

Yue

et al. 2020

Preprint

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Background The coronavirus disease 2019 (COVID-19) pneumonia, outbreak in Wuhan, China, has led to a global pandemic. The high mortality of COVID-19 patients makes it significant to evaluate possible disease progression. This study was designed to explore the prognostic value of Controlling Nutritional Status (CONUT) score in patients with COVID-19. Methods Patients diagnosed with COVID-19 of a single center in Wuhan, China from January 2020 to February 2020 were enrolled in this study. Logistic regression analysis was performed to find independent risk factor of mortality. Receiver operating characteristics (ROC) curve was drawn to evaluate the prognostic value of CONUT score. Results Among 442 included patients, there were 79 non-survivors with mortality of 17.9%. Compared with survivors, the median age (p < 0.001) and male ratio (p = 0.042) were higher in non-survivors. Non-survivors had higher incidence of comorbidities including hypertension (p < 0.001), chronic lung disease (p = 0.001) and cardiovascular disease (p = 0.005). Complications such as respiratory failure(p < 0.001), acute kidney injury (AKI) (p < 0.001) occurred more frequently in non-survivors. Multivariate logistic regression analysis showed that CONUT (p = 0.002), lactate dehydrogenase (LDH) (p < 0.001), C-reactive protein (CRP) (p = 0.020) were risk factor of mortality in COVID-19 patients. Area under the ROC curve (AUC) of CONUT and Nutrition risk screening 2002 (NRS2002) score were 0.813 and 0.795, respectively. Comprised of CONUT, LDH, CRP, the constructed prognostic model had higher AUC of 0.923 (Z = 3.5210, p < 0.001). Conclusion CONUT is an independent risk factor of mortality in COVID-19 patients. Evaluating CONUT is beneficial for clinicians to predict the progression of COVID-19 patients and strengthen monitoring and management to improve prognosis.

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Section: Discussionmentioning

confidence: 99%

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

Wang

Yue

et al. 2020

Preprint

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“…Malnutrition has been proven to be an independent prognostic index of incidence and mortality in patients with various cancers, myocardial infarction (MI) as well as acute ischemic stroke (AIS) [ 9 – 11 ]. The PNI is a novel and comprehensive nutritional-inflammatory score that reflects the immunological nutritional status based on serum albumin concentration and lymphocyte count.…”

Section: Introductionmentioning

confidence: 99%

Prognostic nutritional index predicts clinical outcomes in patients with cerebral venous sinus thrombosis

Zhao

Shen

et al. 2021

BMC Neurol

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Background Lower prognostic nutritional index (PNI) is related to the poor prognosis of cardiovascular diseases. However, little is known about PNI and its relationship with the prognosis of cerebral venous sinus thrombosis (CVST). Methods CVST patients were retrospectively identified from January 2013 till June 2019. Patients in the acute / subacute phase were selected as subjects. Poor prognosis was defined as a modified Rankin Scale (mRS) of 3–6. Multivariate logistic regression analysis was used to confirm if lower PNI was associated with a poor prognosis. Results A total of 297 subjects with follow-up data were enrolled. Thirty-three (11.1%) had a poor outcome. Multivariate logistic regression analysis suggested that PNI was an important predictive factor of poor outcome in acute/subacute CVST (odds ratio, 0.903; 95% CI, 0.833–0.978; P = 0.012). The optimal cut-off value for predicting the poor prognosis of PNI was 44.2. Kaplan-Meier analysis and log-rank test suggested that the lower the PNI value, the higher the mortality rate (P < 0.001). In addition, the nomogram that was set up showed that lower PNI was an index of poor prognosis. The c-index for acute/subacute patients with CVST was 0.872. Conclusion Lower PNI is correlated with a higher risk of adverse clinical outcomes in patients with acute/subacute CVST.

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“…The CONUT score is calculated from the serum albumin value, the total cholesterol level, and the total lymphocyte count [ 7 ], which only included one more indicator than PNI. The CONUT score has been used for assessing the prognosis of heart failure [ 15 ], acute ischemic stroke [ 26 ], and a variety of malignant tumors [ 27 , 28 ]. Recently, the prognostic value of the CONUT score has been validated and shown better than PNI in patients with coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention

et al. 2021

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Background This study aimed to investigate the connection between malnutrition evaluated by the Controlling Nutritional Status (CONUT) score and the risk of contrast-associated acute kidney injury (CA-AKI) in elderly patients who underwent percutaneous coronary intervention (PCI). Methods A total of 1308 patients aged over 75 years undergoing PCI was included. Based on the CONUT score, patients were assigned to normal (0–1), mild malnutrition (2–4), moderate-severe malnutrition group (≥ 5). The primary outcome was CA-AKI (an absolute increase in ≥ 0.3 mg/dL or ≥ 50% relative serum creatinine increase 48 h after contrast medium exposure). Results Overall, the incidence of CA-AKI in normal, mild, moderate-severe malnutrition group was 10.8%, 11.0%, and 27.2%, respectively (p < 0.01). Compared with moderate-severe malnutrition group, the normal group and the mild malnutrition group showed significant lower risk of CA-AKI in models adjusting for risk factors for CA-AKI and variables in univariate analysis (odds ratio [OR] = 0.48, 95% confidence interval [CI]: 0.26–0.89, p = 0.02; OR = 0.46, 95%CI: 0.26–0.82, p = 0.009, respectively). Furthermore, the relationship were consistent across the subgroups classified by risk factors for CA-AKI except anemia. The risk of CA-AKI related with CONUT score was stronger in patients with anemia. (overall interaction p by CONUT score = 0.012). Conclusion Moderate-severe malnutrition is associated with higher risk of CA-AKI in elderly patients undergoing PCI.

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Being at risk of malnutrition predicts poor outcomes at 3 months in acute ischemic stroke patients

Cited by 60 publications

References 31 publications

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

CONUT score is associated with mortality in patients with COVID-19: a retrospective study in Wuhan

Prognostic nutritional index predicts clinical outcomes in patients with cerebral venous sinus thrombosis

Nutritional status and risk of contrast-associated acute kidney injury in elderly patients undergoing percutaneous coronary intervention

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