Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Br J Nutr. 2022 Jul 28;128(2):192-199. doi: 10.1017/S0007114521003184. Epub 2021 Aug 19.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients ( = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
营养风险筛查指数是评估营养风险的标准工具,但在急性出血性脑卒中(AHS)中,控制营养状况(CONUT)作为预后标志物的流行病学数据很少。我们旨在探讨 CONUT 是否可预测 AHS 患者 3 个月的功能结局。共连续招募了 349 例中国 AHS 患者,采用高 CONUT 评分(≥2)确定其营养不良风险。将队列患者分为高-CONUT(≥2)和低-CONUT(<2)组,主要结局为出院后 3 个月改良 Rankin 量表(mRS)评分≥3 的不良功能预后。使用逻辑回归分析,在考虑高-CONUT 和低-CONUT 组之间不平衡变量的额外调整后,估计出院后不良功能预后的比值比(OR)及其 95%置信区间(CI)。共有 328 例患者(60.38±12.83 岁;66.77%为男性)完成了出院后 3 个月的 mRS 评估,其中 172 例患者入院时存在营养风险,104 例患者预后不良。高-CONUT 患者的总胆固醇和总淋巴细胞计数水平明显低于低-CONUT 患者(=0.012 和<0.001)。出院后 3 个月时,与低-CONUT 患者相比,高-CONUT 患者的不良结局风险更高(OR:2.32,95%CI:1.28,4.17)。高-CONUT 评分可独立预测 AHS 患者 3 个月的不良预后,有助于识别需要额外营养管理的患者。