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营养预后指数(NPI)和控制营养状况(CONUT)评分系统在 65 岁以上非 ST 段抬高型心肌梗死患者中的预后价值。

The prognostic value of the nutritional prognostic index (NPI) and controlling nutritional status (CONUT) scoring systems in non-ST elevated myocardial infarction patients over 65 years of age.

机构信息

Cardiology Department, Private Doruk Yıldırım Hospital, Ankara Yolu Cad., No:235, Yıldırım, Bursa, Turkey.

Cardiology Department, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.

出版信息

Aging Clin Exp Res. 2022 Mar;34(3):555-562. doi: 10.1007/s40520-021-02039-y. Epub 2022 Jan 7.

Abstract

BACKGROUND

Nutritional status and metabolic responses to inflammation changes with age and comorbid conditions.

AIMS

We aimed to compare the predictive values of the nutritional prognostic index (NPI) and controlling nutritional status (CONUT) Score systems with the GRACE score in elderly (non-ST elevated myocardial infarction) NSTEMI patients.

METHODS

NSTEMI patients over 65 years of age have been included in this study. The factors affecting mortality were determined by regression analysis. ROC curve analysis were performed and predictiveness of the scores was tested.

RESULTS

Mean age of patients was 74.49 ± 7.60 years, median GRACE and NPI scores were 118 (107-131.50 IQR) and 50.10 (45.30-54.27 IQR), respectively, and CONUT scores ≥ 3 were 24.4% of all patients. 32 (15.6%) patients died within 6 months. White blood cells and albumin levels maintain their significance in the multivariate regression analysis (OR: 1.386; 0.025, p < 0.001, respectively). ROC curve analysis of NPI, CONUT, Killip, and GRACE scores were performed (AUC: 0.757; 0.744; 0.725; 0.800, p < 0.001, respectively).

DISCUSSIONS

The frequency of NSTEMI increases with the effect of increasing age and comorbid conditions. The NPI and CONUT scoring systems have been tested in many previous studies to predict the prognosis of both malignancy and cardiovascular diseases. What makes this scoring system valuable for our study is the thought that our study group will be more prone to malnutrition because they are old and present with an acute presentation.

CONCLUSIONS

NPI and CONUT scoring systems have been successful at rates approaching the GRACE score system, which is used primarily to predict the prognosis of NSTEMI.

摘要

背景

营养状况和代谢对炎症的反应会随年龄和合并症而变化。

目的

我们旨在比较营养预后指数(NPI)和控制营养状态(CONUT)评分系统与 GRACE 评分在老年(非 ST 段抬高型心肌梗死)NSTEMI 患者中的预测价值。

方法

本研究纳入了 65 岁以上的 NSTEMI 患者。通过回归分析确定影响死亡率的因素。进行 ROC 曲线分析,并测试评分的预测性。

结果

患者的平均年龄为 74.49±7.60 岁,中位数 GRACE 和 NPI 评分为 118(107-131.50 IQR)和 50.10(45.30-54.27 IQR),CONUT 评分≥3 的患者占所有患者的 24.4%。6 个月内有 32(15.6%)例患者死亡。白细胞和白蛋白水平在多变量回归分析中仍然具有重要意义(OR:1.386;0.025,p<0.001)。对 NPI、CONUT、Killip 和 GRACE 评分进行了 ROC 曲线分析(AUC:0.757;0.744;0.725;0.800,p<0.001)。

讨论

非 ST 段抬高型心肌梗死的频率随着年龄和合并症的增加而增加。NPI 和 CONUT 评分系统已在许多先前的研究中进行了测试,以预测恶性肿瘤和心血管疾病的预后。使该评分系统对我们的研究有价值的是,我们的研究组由于年龄较大且表现为急性发作,因此更容易出现营养不良的想法。

结论

NPI 和 CONUT 评分系统与主要用于预测 NSTEMI 预后的 GRACE 评分系统的成功率相近。

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