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急性肺栓塞中控制营养状况评分与长期死亡率的关联

Association of controlling nutritional status score and long-term mortality in acute pulmonary embolism.

作者信息

Kalkan Kamuran, Tunca Cagatay, Ozan Tanik Veysel

机构信息

Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Bilkent City Hospital, Ankara, Turkey.

Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2025 Sep;169(3):188-195. doi: 10.5507/bp.2025.019. Epub 2025 Jul 7.

Abstract

BACKGROUND AND AIMS

Pulmonary embolism (PE) is a life-threatening condition with significant short- and long-term mortality risk. Although existing risk stratification models focus on short-term outcomes, the role of nutritional status in predicting long-term mortality remains underexplored. This retrospective study investigated the prognostic value of the Controlling Nutritional Status (CONUT) score, a composite index derived from serum albumin, total cholesterol, and lymphocyte counts.

METHODS

A total of 274 patients with confirmed PE were treated at a tertiary care center between January 2021 and March 2023. The primary endpoint was long-term all-cause mortality, as assessed using hospital records and follow-up interviews.

RESULTS

Multivariate analysis identified the CONUT score as an independent predictor of mortality (odds ratio [OR], 1.298; 95% confidence interval [CI], 1.066-1.580; P=0.009). A cut-off score of 2.5 demonstrated high prognostic accuracy (AUC, 0.844; sensitivity, 89%; specificity, 72%). Patients with higher CONUT scores exhibited increased inflammatory marker levels, lower serum albumin levels, and worse outcomes.

CONCLUSION

These findings highlight CONUT score as a simple and cost-effective tool for assessing nutritional and inflammatory status, enabling improved long-term risk stratification in patients with PE. Future studies should validate these results in diverse populations and evaluate the impact of targeted nutritional and anti-inflammatory interventions on patient outcomes.

摘要

背景与目的

肺栓塞(PE)是一种危及生命的疾病,具有显著的短期和长期死亡风险。尽管现有的风险分层模型侧重于短期结果,但营养状况在预测长期死亡率方面的作用仍未得到充分探索。这项回顾性研究调查了控制营养状况(CONUT)评分的预后价值,该评分是一种由血清白蛋白、总胆固醇和淋巴细胞计数得出的综合指数。

方法

2021年1月至2023年3月期间,共有274例确诊为PE的患者在一家三级医疗中心接受治疗。主要终点是长期全因死亡率,通过医院记录和随访访谈进行评估。

结果

多变量分析确定CONUT评分为死亡率的独立预测因素(比值比[OR],1.298;95%置信区间[CI],1.066 - 1.580;P = 0.009)。临界值为2.5时显示出较高的预后准确性(AUC,0.844;敏感性,89%;特异性,72%)。CONUT评分较高的患者炎症标志物水平升高、血清白蛋白水平降低且预后较差。

结论

这些发现突出了CONUT评分作为一种评估营养和炎症状态的简单且经济有效的工具,能够改善PE患者的长期风险分层。未来的研究应在不同人群中验证这些结果,并评估针对性营养和抗炎干预对患者预后的影响。

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