控制营养状况（CONUT）评分对接受心血管手术患者的预后影响。

The prognostic impact of the controlling nutritional status (CONUT) score in patients undergoing cardiovascular surgery.

机构信息

Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omorinishi, Ota, Tokyo, 143-8541, Japan.

Department of Cardiovascular Surgery, Misato Central General Hospital, 4-5-1, Chuo, Misato, Saitama, 341-8526, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2020 Oct;68(10):1142-1147. doi: 10.1007/s11748-020-01346-x. Epub 2020 Apr 4.

DOI:10.1007/s11748-020-01346-x

PMID:32248407

Abstract

BACKGROUND

Various postoperative predictive markers following cardiovascular surgery have been examined for use in the current aging population. The controlling nutritional status (CONUT) score, which is advocated not only as a screening tool for poor nutritional status, but also as an immunonutritional assessment, has started to attract attention in several clinical settings, such as in cancer and heart failure patients. The aim of this study was to evaluate the value of the CONUT score as a postoperative prognostic marker in patients who underwent cardiovascular surgery.

METHODS

A total of 75 patients who underwent elective cardiovascular surgery between January 2015 and October 2017 were retrospectively analyzed. The patients were divided into two groups according to their preoperative CONUT score (i.e., CONUT < 2 or CONUT ≥ 2), and their clinicopathological characteristics, surgical outcomes, and overall survival were compared. The median follow-up period was 23 months (range 0-43 months) after surgery.

RESULTS

The high CONUT group (CONUT ≥ 2), which consisted of 30 (40.0%) patients, had a significantly worse prognosis than the low CONUT group with regard to overall survival (p = 0.0007). On multivariate analyses, the CONUT score was identified as the only independent prognostic factor for overall survival (hazard ratio 1.47 per 1 CONUT score increase, 95% confidence interval 1.05-2.06, p < 0.026).

CONCLUSIONS

The CONUT score is a reliable and independent preoperative predictor of overall survival after cardiovascular surgery.

摘要

背景

各种心血管手术后的预测标志物已被研究用于当前老龄化人口。控制营养状况（CONUT）评分不仅被认为是一种筛选营养不良的工具，也是一种免疫营养评估，已在多个临床环境中引起关注，如癌症和心力衰竭患者。本研究旨在评估 CONUT 评分作为接受心血管手术患者术后预后标志物的价值。

方法

回顾性分析了 2015 年 1 月至 2017 年 10 月期间接受择期心血管手术的 75 例患者。根据术前 CONUT 评分（即 CONUT < 2 或 CONUT ≥ 2）将患者分为两组，并比较其临床病理特征、手术结果和总体生存率。术后中位随访时间为 23 个月（0-43 个月）。

结果

高 CONUT 组（CONUT ≥ 2）有 30 例（40.0%）患者，其总体生存率明显低于低 CONUT 组（p = 0.0007）。多因素分析显示，CONUT 评分是总体生存率的唯一独立预后因素（每增加 1 CONUT 评分，风险比为 1.47，95%置信区间为 1.05-2.06，p < 0.026）。