控制营养状况评分在急性缺血性脑卒中各亚型中的预后作用
Prognostic role of the controlling nutritional status score in acute ischemic stroke among stroke subtypes.
作者信息
Naito Hiroyuki, Hosomi Naohisa, Nezu Tomohisa, Kuzume Daisuke, Aoki Shiro, Morimoto Yuko, Yoshida Takeshi, Shiga Yuji, Kinoshita Naoto, Ueno Hiroki, Maruyama Hirofumi
机构信息
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Neurology, Chikamori Hospital, Kochi, Japan; Department of Disease Model, Research Institute of Radiation Biology and Medicine, Hiroshima University, Japan.
出版信息
J Neurol Sci. 2020 Sep 15;416:116984. doi: 10.1016/j.jns.2020.116984. Epub 2020 Jun 12.
INTRODUCTION
The association of malnutrition on stroke subtypes has not been well established. We investigated the relationship between malnutrition and functional outcome according to stroke subtypes.
METHODS
Acute consecutive ischemic stroke patients (n = 1915, 73 ± 12 years) were analysed. The nutritional status was evaluated using the Controlling Nutritional Status (CONUT) score, which was calculated from the serum albumin level, lymphocyte count, and total cholesterol level; malnutrition was defined as a CONUT score of 5 to 12. A poor outcome was defined as a modified Rankin Scale score ≥ 3 at 3 months.
RESULTS
Of the 1518 patients, 113 (7.4%) had malnutrition, and 533 (33.1%) had a poor outcome. Among the patients with cardioembolic stroke and stroke of other etiologies, those with malnutrition had higher rates of poor outcomes than those without. After adjusting for age, sex, and baseline stroke severity, malnutrition was independently associated with poor outcomes in patients with cardioembolic stroke and other stroke etiologies (odds ratio 3.25, 95% confidence interval 1.02-10.4, p = .044; 6.22, 2.71-14.3, p < .001, respectively).
CONCLUSIONS
Considering stroke subtype, malnutrition determined using the CONUT score was independently associated with poor outcomes in the patients with cardioembolic stroke or stroke of other etiologies.
引言
营养不良与中风亚型之间的关联尚未明确确立。我们根据中风亚型研究了营养不良与功能预后之间的关系。
方法
对急性连续性缺血性中风患者（n = 1915，73±12岁）进行分析。使用控制营养状况（CONUT）评分评估营养状况，该评分由血清白蛋白水平、淋巴细胞计数和总胆固醇水平计算得出；营养不良定义为CONUT评分为5至12。不良预后定义为3个月时改良Rankin量表评分≥3。
结果
在1518例患者中，113例（7.4%）存在营养不良，533例（33.1%）预后不良。在心源性栓塞性中风和其他病因性中风患者中，营养不良患者的不良预后发生率高于非营养不良患者。在调整年龄、性别和基线中风严重程度后，营养不良与心源性栓塞性中风和其他中风病因患者的不良预后独立相关（比值比分别为3.25，95%置信区间1.02 - 10.4，p = 0.044；6.22，2.71 - 14.3，p < 0.001）。
结论
考虑中风亚型，使用CONUT评分确定的营养不良与心源性栓塞性中风或其他病因性中风患者的不良预后独立相关。
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