Controlling Nutritional Status Score as a Predictive Marker of In-hospital Mortality in Older Adult Patients

Chengyu Liu,Xin Yang,Mingwei Zhu,Hongyuan Cui,Zijian Li,Junmin Wei

doi:10.3389/fnut.2021.738045

Abstract

The controlling nutritional status (CONUT) score assesses nutritional status and is associated with short- and long-term prognoses in some diseases, but the significance of the CONUT score for the prediction of in-hospital mortality in older adults is unknown. The purpose was to determine the importance of the CONUT score for the prediction of in-hospital mortality, short-term complications, length of hospital stay, and hospital costs in older adults. Our retrospective cohort study analyzed data from 11,795 older adult patients from two multicenter cohort studies. We performed receiver operating characteristic curve analysis using in-hospital mortality as the endpoint and determined the appropriate CONUT score cut-off by the Youden index. The patients were divided into two high and low groups according to the CONUT cut-off value, and the differences in clinical characteristics and in-hospital clinical outcomes between the two groups were compared. We compared the accuracy of the CONUT score and other nutrition-related tools in predicting in-hospital mortality by calculating the area under the receiver operating characteristic curve and performed univariate and multivariate analyses of predictors of in-hospital mortality. Among all the patients, 178 (1.5%) patients experienced in-hospital death. The optimal cut-off values was 5.5 for the CONUT score. The high CONUT group had a higher incidence of short-term complications and prolonged hospital stay than the low CONUT group (CONUT score <6), but hospital costs were not significantly higher. The CONUT score had the highest predictive ability for in-hospital mortality among the five nutrition-related parameters compared. Multivariate analysis showed that a high CONUT score (CONUT score ≥ 6) was an independent predictor of in-hospital mortality. In conclusion, the present study demonstrated that the CONUT score could be used to predict in-hospital mortality in older adults.

Highlights

Older adult inpatients have a high incidence of nutritional risk and malnutrition [1]
Our study indicated that Controlling Nutritional Status (CONUT) score can be used as a predictive tool for in-hospital mortality in older adult patients, and older adult patients with high CONUT score have a higher risk of in-hospital death and complications as well as hospital length of stay
Studies suggest that all three components of the CONUT score are associated with short-term prognosis that encompasses in-hospital mortality in older adult patients

Summary

Introduction

Older adult inpatients have a high incidence of nutritional risk and malnutrition [1]. Malnutrition is one of several negative predictors that affect the risk of some diseases in hospitalized patients and can predict adverse clinical outcomes [2, 3]. Current guidelines recommend that routine nutritional screening of all older adult inpatients should include screening for malnutrition with a validated tool to identify malnourished patients [4, 5]. There is currently no gold standard method for diagnosing malnutrition, and many tools need to be applied to assess nutritional status [6]. The predictive role of the CONUT score for in-hospital mortality in older adult inpatients has not been clearly established

Objectives

Methods

Results

Conclusion