Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan.
Sci Rep. 2020 Feb 24;10(1):3320. doi: 10.1038/s41598-020-60404-9.
The high controlling nutritional status (CONUT) score that represents poor nutritional status has been acknowledged to have prognostic implications in chronic heart failure. We aimed to investigate its role in acute decompensated heart failure (ADHF). Using the data from an multicenter registry that enrolled 4056 consecutive patients hospitalized for ADHF in Japan between 2014 and 2016, we analyzed 2466 patients in whom data on the components of the CONUT score at hospital presentation were available. The decrease of lymphocyte count and total cholesterol was assigned with 0, 1, 2, and 3 points and the decrease of albumin was assigned with 0, 2, 4, and 6 points according to the severity. We defined low CONUT score as 0-4 (N = 1568) and high CONUT score as 5-9 (N = 898). The patients in the high CONUT score group were older and more likely to have a smaller body mass index than those in the low CONUT score group. The high CONUT score group was associated with higher rate of death and infection during the index hospitalization compared to the low CONUT score group (9.0% versus 4.4%, and 21.9% versus 12.7%, respectively). After adjusting for confounders, the excess risk of high relative to low CONUT score for mortality and infection was significant (OR: 1.61, 95%CI: 1.05-2.44, and OR: 1.66, 95%CI: 1.30-2.12, respectively). The effect was incremental according to the score. High CONUT score was associated with higher risk for in-hospital mortality and infection in an incremental manner in patients hospitalized for ADHF.
高控制营养状态（CONUT）评分代表营养不良，已被认为对慢性心力衰竭具有预后意义。我们旨在研究其在急性失代偿性心力衰竭（ADHF）中的作用。使用 2014 年至 2016 年期间在日本因 ADHF 住院的多中心登记处的数据，我们分析了在入院时可获得 CONUT 评分成分数据的 2466 例患者。淋巴细胞计数和总胆固醇减少分别被赋值 0、1、2 和 3 分，白蛋白减少根据严重程度分别被赋值 0、2、4 和 6 分。我们将低 CONUT 评分定义为 0-4（N=1568），高 CONUT 评分定义为 5-9（N=898）。与低 CONUT 评分组相比，高 CONUT 评分组的患者年龄较大，体重指数较小。与低 CONUT 评分组相比，高 CONUT 评分组患者在指数住院期间死亡和感染的发生率更高（9.0%对 4.4%，21.9%对 12.7%）。在调整混杂因素后，高 CONUT 评分相对于低 CONUT 评分的死亡和感染风险增加具有统计学意义（OR：1.61，95%CI：1.05-2.44，和 OR：1.66，95%CI：1.30-2.12，分别）。这种效应是递增的。高 CONUT 评分与 ADHF 住院患者的住院死亡率和感染风险呈递增关系。
