Matysiak Konrad, Hojdis Aleksandra, Szewczuk Magdalena
Centre for Intestinal Failure, Poznan University of Medical Sciences, 60-355 Poznań, Poland.
Department of Gastroenterology, Poznan University Hospital, 60-355 Poznań, Poland.
Nutrients. 2024 Nov 26;16(23):4052. doi: 10.3390/nu16234052.
The management of chronic intestinal failure (CIF) secondary to advanced gastric cancer poses clinical challenges. This study explores the correlation between the Controlling Nutritional Status (CONUT) index and survival in patients with TNM stage IV gastric cancer on home parenteral nutrition (HPN).
From 2015 to 2023, 410 patients (37% women, 63% men) with CIF due to advanced gastric cancer were assessed using CONUT scores, BMI, and biochemical tests. The Cox proportional hazards model was used to evaluate the impact of covariates on survival. Logistic regression categorized malnutrition levels by CONUT scores, with performance evaluated using precision, recall, and F1 scores. A -value < 0.001 was statistically significant.
The CONUT scores were independent predictors of survival, with higher CONUT scores increasing mortality risk (HR = 2.073, 95% CI: 1.815-2.369, < 0.001). The model achieved an overall accuracy of 71%, indicating correct classification for the majority of cases.
CONUT scores are key predictors of survival in patients receiving HPN for CIF due to stage IV gastric cancer.
晚期胃癌继发慢性肠衰竭（CIF）的管理面临临床挑战。本研究探讨控制营养状况（CONUT）指数与接受家庭肠外营养（HPN）的IV期胃癌患者生存率之间的相关性。
2015年至2023年，对410例因晚期胃癌导致CIF的患者（37%为女性，63%为男性）进行CONUT评分、体重指数（BMI）和生化检查评估。采用Cox比例风险模型评估协变量对生存率的影响。通过CONUT评分对营养不良水平进行逻辑回归分类，使用精确率、召回率和F1分数评估性能。P值<0.001具有统计学意义。
CONUT评分是生存率的独立预测因素，CONUT评分越高，死亡风险越高（风险比[HR]=2.073，95%置信区间[CI]：1.815-2.369，P<0.001）。该模型的总体准确率为71%，表明大多数病例分类正确。
CONUT评分是因IV期胃癌接受HPN治疗的CIF患者生存率的关键预测因素。
