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评估控制营养状况评分对急性失代偿性心力衰竭患者住院期间全因死亡率的预测价值:一项来自中国江西的回顾性队列研究。

Assessing the predictive value of the controlling nutritional status score on all-cause mortality during hospitalization in patients with acute decompensated heart failure: a retrospective cohort study from Jiangxi, China.

作者信息

Huang Xin, Qiu Jiajun, Kuang Maobin, Wang Chao, He Shiming, Yu Changhui, Xie Guobo, Sheng Guotai, Zou Yang

机构信息

Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.

出版信息

Front Nutr. 2024 Jul 5;11:1392268. doi: 10.3389/fnut.2024.1392268. eCollection 2024.

Abstract

OBJECTIVE

Nutritional status is closely associated with the prognosis of heart failure. This study aims to assess the relationship between the Controlling Nutritional Status (CONUT) score and in-hospital mortality among patients with acute decompensated heart failure (ADHF) in Jiangxi, China.

METHODS

A retrospective cohort study was conducted. Multivariable Cox regression models and restricted cubic spline regression were employed to evaluate the relationship between the CONUT score and in-hospital mortality in ADHF patients from Jiangxi, China. The predictive value of the CONUT score for in-hospital mortality in ADHF patients was analyzed using receiver operating characteristic curves. Subgroup analyses were performed to identify risk dependencies of the CONUT score in specific populations.

RESULTS

The study included 1,230 ADHF patients, among whom 44 (3.58%) mortality events were recorded. After adjusting for confounding factors, a positive correlation was found between the CONUT score and the risk of in-hospital mortality in ADHF patients. Restricted cubic spline regression analysis indicated a non-linear relationship between the CONUT score and the risk of in-hospital mortality in ADHF patients, estimating a rapid increase in mortality risk when the CONUT score exceeded 5. Receiver operating characteristic analysis demonstrated a good predictive value of the CONUT score for all-cause mortality events in ADHF patients [area under the curve = 0.7625, optimal threshold = 5.5]. Additionally, a relatively higher risk associated with the CONUT score was observed in male patients and those with concomitant cerebral infarction.

CONCLUSION

This study reveals a positive correlation between the CONUT score and the risk of in-hospital mortality in ADHF patients. Based on the findings of this study, we recommend maintaining a CONUT score below 5 for patients with ADHF in Jiangxi, China, as it may significantly contribute to reducing the risk of in-hospital all-cause mortality.

摘要

目的

营养状况与心力衰竭的预后密切相关。本研究旨在评估在中国江西急性失代偿性心力衰竭(ADHF)患者中,控制营养状况(CONUT)评分与住院死亡率之间的关系。

方法

进行一项回顾性队列研究。采用多变量Cox回归模型和受限立方样条回归来评估中国江西ADHF患者中CONUT评分与住院死亡率之间的关系。使用受试者工作特征曲线分析CONUT评分对ADHF患者住院死亡率的预测价值。进行亚组分析以确定CONUT评分在特定人群中的风险依赖性。

结果

该研究纳入了1230例ADHF患者,其中记录了44例(3.58%)死亡事件。在调整混杂因素后,发现ADHF患者的CONUT评分与住院死亡风险呈正相关。受限立方样条回归分析表明ADHF患者的CONUT评分与住院死亡风险之间存在非线性关系,估计当CONUT评分超过5分时,死亡风险迅速增加。受试者工作特征分析表明CONUT评分对ADHF患者全因死亡事件具有良好的预测价值[曲线下面积 = 0.7625,最佳阈值 = 5.5]。此外,在男性患者和伴有脑梗死的患者中观察到与CONUT评分相关的风险相对较高。

结论

本研究揭示了ADHF患者的CONUT评分与住院死亡风险之间存在正相关。基于本研究的结果,我们建议中国江西的ADHF患者将CONUT评分维持在5分以下,因为这可能有助于显著降低住院全因死亡风险。

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