那不勒斯预后评分与老年人中风及死亡率之间的关联。

Associations between naples prognostic score and stroke and mortality among older adults.

作者信息

Song Junting, Yin Lin

机构信息

Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, 116021, Liaoning, People's Republic of China.

出版信息

Eur J Med Res. 2025 Apr 24;30(1):327. doi: 10.1186/s40001-025-02613-4.

DOI:10.1186/s40001-025-02613-4

PMID:40275420

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12020056/

Abstract

BACKGROUND

Inflammation and malnutrition in the body are closely related to the incidence of stroke. Older adults often suffer from malnutrition and inflammation. Naples Prognostic Score (NPS), a novel inflammation-malnutrition score, can effectively assess the inflammation and nutritional status of the body. The aim of this study is to explore the connection between NPS and stroke among older adults, as well as the association between NPS and mortality in older adults.

METHODS

Participants eligible for the study were collected from National Health and Nutrition Examination Survey(NHANES) data from 1999 to 2018. Logistic regression models were employed to investigate the link between NPS and stroke. Additionally, restricted cubic spline was utilized to explore the correlations. Subgroup analysis was adopted in order to ensure the credibility of the results. Kaplan-Meier Survival curve and cox regression models and were utilized to evaluate the link between NPS and mortality among older adults.

RESULTS

16,940 older adults qualified for analysis. The participants with stroke had higher levels of NPS. In the logistic regression model, NPS was positively related to stroke (high NPS vs. low NPS, OR = 1.70 (95% CI 1.24-2.35), P < 0.001). Restricted cubic spline revealed a positive non-linear relationship (P for overall < 0.001, P for non-linear < 0.001). Subgroup analysis showed that the association between NPS and the incidence of stroke is more significant in the non-diabetes population (P < 0.001). The Kaplan-Meier curve shows that patients with high NPS have a significantly higher risk of all-cause mortality and cardiovascular mortality (P < 0.001). In the Cox regression model, a positive correlation was observed between NPS and mortality among older adults (all-cause mortality: HR = 1.36 (95% CI 1.30-1.42); cardiovascular mortality:HR = 1.59 (95% CI 1.45-1.75)).

CONCLUSIONS

A positive link was observed between NPS and stroke and mortality. Routine NPS screening may enhance risk stratification in geriatric clinics.

摘要

背景

体内炎症和营养不良与中风的发生率密切相关。老年人常患有营养不良和炎症。那不勒斯预后评分（NPS）是一种新型的炎症-营养不良评分，可有效评估身体的炎症和营养状况。本研究的目的是探讨老年人中NPS与中风之间的联系，以及NPS与老年人死亡率之间的关联。

方法

符合研究条件的参与者来自1999年至2018年的美国国家健康和营养检查调查（NHANES）数据。采用逻辑回归模型研究NPS与中风之间的联系。此外，使用受限立方样条来探索相关性。采用亚组分析以确保结果的可信度。采用Kaplan-Meier生存曲线和Cox回归模型来评估NPS与老年人死亡率之间的联系。

结果

16940名老年人符合分析条件。中风患者的NPS水平较高。在逻辑回归模型中，NPS与中风呈正相关（高NPS与低NPS相比，OR = 1.70（95%CI 1.24-2.35），P < 0.001）。受限立方样条显示出正的非线性关系（总体P < 0.001，非线性P < 0.001）。亚组分析表明，在非糖尿病人群中，NPS与中风发生率之间的关联更为显著（P < 0.001）。Kaplan-Meier曲线显示，高NPS患者的全因死亡率和心血管死亡率风险显著更高（P < 0.001）。在Cox回归模型中，观察到NPS与老年人死亡率之间存在正相关（全因死亡率：HR = 1.36（95%CI 1.30-1.42）；心血管死亡率：HR = 1.59（95%CI 1.45-1.75））。