Association of “Controlling Nutritional Status Index” and “Prognostic Nutritional Index” with intensive care unit survival in elderly patients

Abstract

ObjectivesProviding proper nutritional support for the intensive care unit (ICU) patients is only possible with assessment of malnutrition. In this study, we aimed to evaluate associations between nutritional indexes which were developed to assess malnutrition using blood parameters, and survival among elderly patients in the ICU. Patients and methodsPatients older than 65 years of age and monitored in the ICU, were retrospectively screened with nutritional indexes in order to assess the nutritional status. Each patient was evaluated with both “Controlling Nutritional Status Index” (CONUT) which includes albumin, total cholesterol, total lymphocyte counts, and “Prognostic Nutritional Index” (PNI) which includes only albumin beside total lymphocyte count. ResultsTwo hundred twenty five patients were enrolled in this study. Median age was 79 (range: 65–100). One hundred and eleven (49.3%) patients died during intensive care follow-up. CONUT and PNI scores displayed significant differences between patients who died and who were discharged (P=0.02 and P=0.03, respectively). Kaplan–Meier analysis revealed that high CONUT (≥5) and low PNI (<40) scores were associated with intensive care unit survival but statistical significance was not provided for PNI (P=0.04 and P=0.06, respectively). ConclusionBoth CONUT and PNI indexes seems associated with survival but only CONUT score provides statistically significant prognostic information and may serve as a cost-effective nutritional assessment tool in elderly patients. Because this association did not retain its significance on multivariate analysis, the validity of this index in elderly patients should be further evaluated by prospective studies including larger samples.