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初始控制营养状态评分对首次缺血性脑卒中患者的功能结局、并发症和死亡率的预测意义。

The Significance of an Initial Controlling Nutritional Status Score in Predicting the Functional Outcome, Complications, and Mortality in a First-Ever Ischemic Stroke.

机构信息

Department of Rehabilitation Medicine, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Republic of Korea.

Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.

出版信息

Nutrients. 2024 Oct 12;16(20):3461. doi: 10.3390/nu16203461.

Abstract

BACKGROUND AND PURPOSE

Nutritional status can influence the outcomes and mortality of various diseases. The association between initial nutritional status and ischemic stroke outcomes, however, remains poorly understood. This study investigated whether the Controlling Nutritional Status (CONUT) score at admission could predict functional recovery, complications, and survival following an ischemic stroke.

METHODS

We enrolled a total of 938 patients experiencing their first acute ischemic stroke and categorized them into three groups based on their CONUT score at admission: CONUT 0-1, CONUT 2-4, and CONUT 5-12. The CONUT score was assessed using the serum albumin, total cholesterol, and lymphocyte count. We evaluated the incidence of complications during their hospital stay. Outcomes, including the Modified Rankin Scale (mRS), Functional Independence Measurement (FIM), Functional Ambulatory Classification (FAC), and mortality, were assessed at baseline, as well as at three and six months post-stroke.

RESULTS

CONUT scores were significantly associated with functional outcomes (mRS, FIM, and FAC) and mortality during the six-month follow-up period post-stroke (all < 0.05). The CONUT 5-12 group exhibited significantly poorer improvements in mRS, FIM, and FAC scores (all < 0.05) and a lower survival rate ( < 0.01) during the six-month follow-up compared to the CONUT 0-1 and CONUT 2-4 groups. Additionally, the incidence of pneumonia, urinary tract infections, pressure sores, falling injuries, and fractures was significantly higher in the CONUT 5-12 group than in the other groups (all < 0.01).

CONCLUSIONS

CONUT scores at admission are associated with functional recovery, mortality, and the incidence of complications following a first-ever ischemic stroke. Consequently, the early identification of patients at risk of malnutrition via CONUT scores can be crucial in enhancing patient assessment after an acute stroke.

摘要

背景与目的

营养状况会影响各种疾病的结局和死亡率。然而,初始营养状况与缺血性脑卒中结局之间的关系仍知之甚少。本研究旨在探讨入院时的控制营养状况(CONUT)评分是否可以预测缺血性脑卒中后患者的功能恢复、并发症和生存情况。

方法

我们共纳入了 938 例首次发生急性缺血性脑卒中的患者,并根据入院时的 CONUT 评分将其分为三组:CONUT 0-1 分、CONUT 2-4 分和 CONUT 5-12 分。CONUT 评分通过血清白蛋白、总胆固醇和淋巴细胞计数来评估。我们评估了住院期间并发症的发生率。在基线以及脑卒中后 3 个月和 6 个月评估结局,包括改良 Rankin 量表(mRS)、功能独立性测量(FIM)、功能性步行分类(FAC)和死亡率。

结果

CONUT 评分与脑卒中后 6 个月的功能结局(mRS、FIM 和 FAC)和死亡率显著相关(均<0.05)。CONUT 5-12 分组 mRS、FIM 和 FAC 评分的改善明显较差(均<0.05),且 6 个月随访期间的生存率较低(<0.01),与 CONUT 0-1 分和 CONUT 2-4 分组相比。此外,CONUT 5-12 分组的肺炎、尿路感染、压疮、跌倒伤和骨折的发生率明显高于其他两组(均<0.01)。

结论

入院时的 CONUT 评分与首次缺血性脑卒中后功能恢复、死亡率和并发症的发生相关。因此,通过 CONUT 评分早期识别有营养不良风险的患者,对于增强急性脑卒中后患者的评估至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1351/11509889/364b0ca1a96c/nutrients-16-03461-g001.jpg

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