Course Of Treatment Research Articles

Traditional clinical vignettes, though widely used in medical education, often focus on prototypical presentations; require substantial time and effort to develop; and fail to represent patient diversity, the complexity of clinical conditions, patients' perspectives, and the dynamic nature of physician-patient interactions. This study aimed to evaluate the quality of Japanese-language physician-patient dialogues produced by generative artificial intelligence (AI), focusing on their medical accuracy and overall appropriateness as medical interviews. We created an AI prompt that included a specific clinical history and instructed the model to simulate a cooperative patient responding to the physician's questions to generate a physician-patient dialogue. The target diseases were those covered by the Japanese National Medical Licensing Examination. Each dialogue consisted of 25 turns by the physician and 25 by the patient, reflecting the typical volume of conversation in Japanese outpatient settings. Three internists independently evaluated each generated dialogue using a 7-point Likert scale across 6 criteria: coherence of the conversation, medical accuracy of the patient's responses, medical accuracy of the physician's responses, content of the medical history, communication skills, and professionalism. In addition, a composite score for each dialogue was calculated as the overall mean of these 6 criteria. Each dialogue was also examined for the presence of 5 essential clinical components commonly included in medical interviews: chief concern and clinical course since onset, physical findings, test results, diagnosis, and treatment course. A dialogue was considered to include a component only if all 3 evaluators independently confirmed its presence. The mean composite score was 5.7 (SD 1.0), indicating high overall quality. Mean scores for each criterion were as follows: coherence of the conversation, 5.9 (SD 0.9); medical accuracy of the patient's responses, 6.0 (SD 0.9); medical accuracy of the physician's responses, 5.6 (SD 1.1); content of medical history taking, 5.9 (SD 0.9); communication skills, 5.6 (SD 0.9); and professionalism, 5.5 (SD 1.1). Among the 5 clinical components assessed in each dialogue across 47 clinical cases, chief concern and clinical course were included in all 47 (100%) cases, physical findings in 15 (32%) cases, test results in 27 (57%) cases, diagnosis in 45 (96%) cases, and treatment course in 0 (0%) cases. While physician oversight remains essential, it is feasible to efficiently create AI-generated educational materials for medical education that overcome the limitations of traditional clinical vignettes. This approach may reduce time and financial burdens, enhancing opportunities to practice clinical interviewing in settings that closely mirror real-world encounters.

Older women (>65 years) diagnosed with breast cancer may be at risk for chemotherapy dose reductions. We evaluated associations of age at diagnosis with two measures of chemotherapy dose reductions: first cycle dose proportion (FCDP) <90%, and average relative dose intensity (ARDI) <90%. From the Optimal Breast cancer Chemotherapy Dosing study, we included 10,166 women aged 18+ years treated with adjuvant chemotherapy for stage I-IIIA breast cancer at Kaiser Permanente Northern California (KPNC) and Washington (KPWA) between 2004-2019. We examined associations between age at diagnosis with FCDP < 90% (reflecting clinician intent at chemotherapy initiation) and ARDI < 90% (reflecting average dose across the chemotherapy course). We used generalized linear models of the Poisson family with a log-link function and robust standard errors to calculate prevalence ratios (PR) for FCDP < 90% and ARDI < 90% with 95% confidence intervals (CI) adjusted for patient and tumor characteristics, with and without adjusting for pre-existing comorbidities. All tests for statistical significance were 2-sided. The proportion of women with FCDP < 90% ranged from 2.9% among women aged 18-39 years to 18.6% among women aged 75+ years. Before adjusting for comorbidities, women aged 75+ years were more likely to have FCDP < 90% (PR: 4.88; 95%CI: 3.58, 6.66) and ARDI < 90% (PR: 1.91; 95%CI: 1.58, 2.32) versus women aged 40-49 years. Results were similar after adjusting for comorbidities as a composite comorbidity score or individual comorbidities. Older age at diagnosis was strongly associated with chemotherapy dose reductions in this population-based cohort, particularly at chemotherapy initiation but also across the course of treatment.

People receiving treatment for advanced cancer invest substantial portions of their survival time receiving healthcare, labelled the 'time toxicity' of treatment. Although qualitative research has examined the impact of time burden on patients and their caregivers, its influence on treatment decision-making is unclear. Our objective was to explore treatment decision-making with patients with advanced gastrointestinal cancer, their caregivers, and oncologists, and unmask the role of time burden in those decisions. The objective was to inform the design of a subsequent discrete-choice experiment (DCE) investigating the importance of time burden in treatment decision-making. A two-step process was used. Factors relevant to treatment decision-making were discussed as part of semi-structured interviews. Responses were analysed using thematic analysis with a focus on measurable themes relevant to the development of candidate attributes for a DCE. Second, we reviewed stated-preferences studies in the field of treatment decision-making in cancer and compared the results with the candidate attributes identified from interviews. Interviews with 45 participants (20 patients, 10 caregivers,15 gastrointestinal oncologists; 53% metropolitan) revealed 4 themes and 6 candidate attributes: expected survival benefit of treatment, impact of physical side effects, effect on day-to-day functioning, route of administration, healthcare contact days, and planned length of the treatment course. Review of 45 published studies yielded no additional attributes. This study identified six candidate attributes for a forthcoming DCE on time burden in advanced cancer care. These findings support growing efforts to quantify and address time toxicity in cancer treatment decision-making.

Background Diabetic ketoacidosis (DKA) is a severe hyperglycemic emergency characterized by metabolic acidosis and electrolyte disturbances. The optimal strategy for potassium replenishment in DKA remains incomplete. This study comprehensively characterized potassium disturbances in DKA and evaluated the effectiveness of potassium replenishment strategies, with a focus on the risk of hypokalemia during treatment. Methods In this multicentre retrospective cohort study, we enrolled the consecutive DKA patients admitted to seven tertiary centres across eastern, central and western China (1 January 2021–31 December 2023). Demographics, biochemical parameters and daily potassium chloride (KCl) replenishment were extracted and evaluated. We used multivariable logistic regression to identify predictors of hypokalaemia during treatment, internally validated the model, and constructed a practical nomogram. Results A total of 571 eligible subjects were included in the analysis. On admission, blood glucose, arterial pH, HCO 3 - , and electrolyte profiles were seriously deteriorated. Among the patients, 95 patients (16.6%) were hypokalemic, 352 (61.6%) normokalemic and 124 (21.7%) hyperkalemic. Hyperkalemia was more frequent in severe DKA and associated with renal impairment and the severity of DKA ( p &amp;lt; 0.05). During treatment, 388 (67.9%) patients developed hypokalemia, the proportion rose to 73.6% among severe DKA cases. The occurrence of hypokalemia during treatment was independently associated with potassium concentration, HbA1c, and arterial pH at admission ( p &amp;lt; 0.05). The statistical model predicted the risk of hypokalemia during treatment. A daily 6.0 g KCl supplement offered superior predictive efficacy for hypokalemia compared to lower doses throughout the treatment course. Conclusions Potassium imbalances were highly prevalent in DKA. Although hyperkalemia was more common on admission, hypokalemia frequently developed during treatment. Daily 6.0 g KCl replenishment was superior to lower doses in predicting hypokalaemia. This study provided the full spectrum of potassium disorders in DKA and delivered an evidence-based, patient-specific replenishment framework.

Managing hand injuries in patients with concurrent psychiatric illness poses a significant challenge in patient care. An increasing segment of literature has also linked worse surgical and nonsurgical outcomes to patients with underlying psychiatric disease. As a result, the goal of this case series is to highlight the common themes seen in psychiatric patients who experience hand injuries and the factors that challenge the recovery, treatment, and overall outcome.The study was conducted in our hand therapy clinic. Outpatient clinic records were scanned from December 2023 to March 2024. Patients who had hand injuries with psychiatric history were identified in the health record retrospectively. Data on patient demographics, psychiatric condition, mechanism of injury, hospital course, and insurance status were collected.Seven patients with hand injury and psychiatric history were identified. Among the 7 patients in this study, 6 of them had depression, 4 had bipolar disorder, 4 had polysubstance use disorder, 3 had suicidal ideation with self-harm behaviors, 2 had anxiety, 2 had borderline personality disorder, and 2 had ADHD. Four patients self-discharged against medical advice on their initial admission. Five patients were lost to follow-up prior to completing their course of treatment, 3 of which were indicated for further plastic surgery. These patients also either had public insurance or were uninsured. Charts were reviewed and various barriers to health care were identified.This study showcases the obstacles to patient care continuity associated with psychiatric comorbidities and how they impact the management of hand injuries. Patients in this population face significant barriers in access to care. This leads to an increase in nonadherence to treatment protocols and delays their recovery. Management of patients with opioid use disorder or uninsured status was further complicated by the limitation of treatment options and loss to follow-up. Patients with psychiatric comorbidities compounded by hand trauma not only need a multidisciplinary approach but also integrated care. This may reduce the number of patients lost to follow-up and improve patient outcomes.

Real-world experience with cladribine in the two years since treatment start: A systematic review and meta-analysis.

Background/Objectives: Lipedema is a chronic disorder characterized by disproportionate fat accumulation in the extremities, causing pain, bruising, and reduced mobility. When conservative therapy fails, liposuction is considered an effective treatment option. Prior studies often relied on subjective or non-standardized measures, limiting precision. This study aimed to objectively assess volumetric changes after liposuction in stage III lipedema using high-resolution 3D imaging to quantify postoperative changes in circumference and volume, providing individualized yet standardized outcome measures aligned with precision medicine. Methods: We retrospectively analyzed 66 patients who underwent 161 water-assisted liposuctions (WALs). Pre- and postoperative measurements were performed with the VECTRA© WB360 system, allowing reproducible, anatomically specific quantification of limb volumes and circumferences. Secondary endpoints included in-hospital complications. Results: Liposuction achieved significant reductions in all treated regions, most pronounced in the proximal thigh and upper arm. Thigh volume decreased by 4.10–9.25% (q &lt; 0.001), while upper arm volume decreased by 15.63% (left) and 20.15% (right) (q = 0.001). Circumference decreased by up to 5.2% in the thigh (q &lt; 0.001) and 12.27% (q = 0.001) in the upper arm. All changes were calculated relative to baseline values, allowing personalized interpretation of treatment effects. Conclusions: This is the first study to objectively quantify postoperative lipedema changes using whole-body 3D surface imaging. By capturing each patient’s contours pre- and postoperatively, this approach enables individualized evaluation while permitting standardized comparison across patients. It offers a precise understanding of surgical outcomes and supports integration of precision medicine principles in lipedema surgery.

Efficacy of topical Ivermectin in controlling human Demodex infestation: Evidence from systematic review and meta-analysis.

Histologic Classifier of Radiosensitivity to Spine Stereotactic Body Radiation Therapy.

Treatment outcomes of Class II subdivision with clear aligners: A retrospective study.

Patients who have been treated in intensive care units (ICUs) display a multitude of physical, cognitive, and/or mental impairments that are collectively called post-intensive care syndrome (PICS). People with PICS have difficulty returning to everyday life. In this narrative review, we present epidemiologic data, risk factors, and approaches to the prevention and treatment of PICS, along with the evidence supporting them. Preliminary findings on the prevalence of PICS and the frequency of treatment for it have been obtained at the PICS outpatient clinic at the Charité-Universitätsmedizin Berlin, where patients are evaluated three months after discharge from an ICU along the three domains of PICS: physical function, cognitive performance, and mental health. These findings yield an overall picture of the everyday reality of post-ICU patient care. Knowledge of the predisposing factors for PICS (sex, old age, pre-existing mental disorders) and of its precipitating factors (stressful experiences in the ICU, severity of illness, delirium), which may change over the course of treatment, enables clinicians to identify patients at risk of PICS and to pursue preventive strategies while they are still being treated in the ICU. Specialized aftercare consists of a wide variety of multidisciplinary treatments whose efficacy remains to be conclusively demonstrated. These include guidance by a physician, patient education, physiotherapy, psychosocial care, and self-help groups. According to the initial findings of the PICS outpatient clinic at the Charité, Campus Virchow Klinikum, 72% (298/417) of patients suffer from impairment in at least one PICS domain three months after discharge from an ICU. The analysis of treatment frequency revealed that half of all patients visited the PICS outpatient clinic in addition to their family physician's practice in at least two three-month periods after their ICU discharge. The specialized, multiprofessional care of patients who have been discharged from an ICU, and of their family members, requires an understanding of the complex pertinent risk factors and courses of illness. It would be desirable for cross-sector care strategies to be established with better integration of rehabilitative services, specialized aftercare facilities, nursing facilities, and primary care practices.

Deep-seated infections caused by AmpC-producing Enterobacterales (AmpC-E) pose challenges due to high bacterial burdens, altered pharmacokinetics, and the inoculum effect. While cefepime and carbapenems are used for bloodstream infections, their comparative effectiveness for deep-seated AmpC-E infections remains uncertain. This retrospective cohort study (2010-2023) evaluated adult inpatients with deep-seated infections caused by AmpC-E (Enterobacter cloacae complex, Klebsiella aerogenes, or Citrobacter freundii). Patients received cefepime or a carbapenem within 48 hours of index culture for ≥72 hours. Definitive therapy (high-dose cefepime or a carbapenem) was administered for ≥70% of the treatment course. The primary outcome was clinical failure, defined as (i) all-cause mortality within 30 days of index culture or (ii) infection recurrence within 30 days after completion of definitive therapy. Pooled logistic regression with inverse probability treatment weighting (IPTW) and time-varying covariates (year of therapy start, time to source control) estimated predictors of failure. Of 480 patients (cefepime n = 243, carbapenem n = 237), E. cloacae complex accounted for 63.9% of infections. Unadjusted 30-day clinical failure rates were similar (14.8% for cefepime vs 11.4% for carbapenem; P = 0.267). After IPTW, carbapenem therapy had lower odds of clinical failure (adjusted odds ratio [aOR], 0.44; 95% confidence interval [CI], 0.29-0.83; P = 0.033). Intensive care unit (ICU) admission increased failure odds (aOR, 2.39; 95% CI, 1.70-3.35; P < 0.001); source control reduced them (aOR, 0.52; 95% CI, 0.40-0.68; P = 0.029). Carbapenem therapy is associated with lower adjusted odds of clinical failure than cefepime in deep-seated AmpC-E infections. ICU admission was independently associated with increased odds of clinical failure, while source control was associated with reduced odds of failure.

Myeloid-derived suppressor cells (MDSCs) are immunosuppressive cells whose levels in peripheral blood are elevated in multiple myeloma (MM) and are closely associated with disease progression and treatment response. This study used flow cytometry to assess MDSC proportions in peripheral blood mononuclear cells from 26 MM patients and 5 with nutritional anemia. T-test and 1-way analysis of variance were used for statistics. The correlation between MDSCs and M protein type, light chain subtype, risk stratification, and disease stage was also investigated. Compared to controls, MM patients had significantly higher levels of granulocytic (G-MDSC) and monocytic (M-MDSC) subsets (P < .05). G-MDSC levels were notably increased in light chain MM (9.23 ± 2.02) compared to IgG (4.06 ± 2.85, P = .004) and IgA subtypes (2.83 ± 2.14, P = .001). M-MDSC levels were significantly higher in κ light chain MM (3.11 ± 3.16) than in λ subtype (1.17 ± 0.74, P = .023). No significant correlation was found between MDSC subsets and risk stratification (G-MDSC: R = 0.13, P = .53; M-MDSC: R = 0.12, P = .57). Patients with relapsed MM showed elevated M-MDSC levels (mean 1.18) compared to controls (mean 0.57, P = .04), and patients with remission MM showed elevated M-MDSC levels (mean 2.58) compared to controls (mean 0.57, P = .01). While G-MDSC levels showed no significant difference (P > .05). After 2 treatment courses, both M-MDSC (1.23 ± 0.53 vs 2.76 ± 3.42, P = .03) and G-MDSC (1.09 ± 0.93 vs 5.57 ± 2.38, P < .001) levels significantly decreased. MDSCs are elevated in MM, and G-MDSC is positively associated with specific M protein subtypes and disease progression. Regulating MDSC expression may offer a novel strategy for MM treatment.

To explore the effects of Yanghe Pingchuan granules combined with inhaled Western medication on the clinical efficacy and serum inflammatory cytokine levels in patients with kidney deficiency and phlegm-turbid-type chronic obstructive pulmonary disease (COPD) in the stable phase. Using the retrospective analysis method, we collected 108 patients with kidney deficiency and phlegm-turbid-type COPD in the stable phase admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2020 to December 2021, and divided them into a combined group and a control group according to medication method, with 56 cases in the combined group and 52 in the control group. In the control group, Budesonide and Formoterol Dry Powder Inhaler was given, and in the combined group, Yanghe Pingchuan granules were added on that basis, with a treatment course of 2 weeks. We compared the TCM syndrome score, post-treatment efficacy, pulmonary functions (forced expiratory volume in one second [FEV1], forced vital capacity [FVC], FEV1/FVC, distance of six-minute walking test [6MWT]), COPD assessment test (CAT) score, and changes in serum inflammatory cytokines (IL-6, IL-10, IL-17, LTB4) levels in the 2 groups. After treatment, the total effective rate of the combined group was 91%, significantly higher than that of the control group, which was 75% (P < .05). After the treatment, the TCM syndrome score, pulmonary functions (FEV1, FVC, FEV1/FVC, 6MWT), CAT score, and changes in serum inflammatory cytokines (IL-6, IL-10, IL-17, LTB4) levels in the 2 groups decreased compared with those before treatment (P < .01), and all of the above indexes, except the pulmonary function FEV1/FVC ratio, in the combined group were better than those in the control group (P < .05). Yanghe Pingchuan granules combined with inhaled Western medication has better clinical efficacy than single inhaled Western medication in patients with kidney deficiency and phlegm-turbid-type COPD in the stable phase, by significantly improving clinical symptoms, enhancing the pulmonary functions, and reducing the inflammation level.

Background/AimProstate cancer (PCa) patients with an initial prostate-specific antigen (PSA) level >1,000 ng/ml at diagnosis represent a rare and high-risk subgroup for which prognostic factors remain poorly defined. Therefore, we investigated the clinical features of this population and identified predictors of overall survival (OS).Patients and MethodsThe present study retrospectively analyzed 35 patients diagnosed with PCa and initial PSA >1,000 ng/ml at our institution between August 2013 and December 2024. Clinical characteristics, treatment courses, PSA responses, and survival outcomes were collected. A nadir PSA level ≤0.2 ng/ml and a 90% decline in PSA from baseline (PSA90) were evaluated. OS was estimated using the Kaplan-Meier method, and the impact of clinical variables on OS was assessed using univariate and multivariate Cox proportional hazards regression models.ResultsMedian age was 74 years, and median initial PSA was 3,027 ng/ml. The median time to castration-resistant prostate cancer was 18.25 months, and median OS was 55.0 months. Univariate analyses revealed that PSA90 achievement correlated with longer OS, whereas age ≥75 years, an Eastern Cooperative Oncology Group performance status ≥1, elevated lactate dehydrogenase, and elevated C-reactive protein correlated with shorter OS. Multivariate analyses identified PSA90 achievement as the only independent predictor of prolonged OS (hazard ratio=0.13).ConclusionThese results suggest the potential of PSA90 as a simple and valuable early biomarker for prognostic stratification in patients with PCa and initial PSA >1,000 ng/ml.

Extramedullary plasmacytoma is a rare tumor, that primarily occurs in the head and neck region. We report a case series on head and neck extramedullary plasmacytoma treated with radiation therapy to provide insights regarding clinical outcomes. This was a retrospective study on radiation therapy outcomes in patients with head and neck extramedullary plasmacytoma treated between January 2010 and December 2024. The treatment course was evaluated, in terms of local tumor control rates and treatment-related toxicities. A total of 200 plasmacytoma patients were screened, and 6 patients with extramedullary disease were included in the study. The most common site of occurrence was the larynx. Radiation therapy was administered at a dose of 45-50Gy in 20-25 fractions. At a mean follow-up of 8years, overall survival and disease-free survival were 8 and 7years, respectively. A local control rate of 83% was achieved through radiation therapy alone. One of six patients progressed to multiple myeloma at 3months; and all patients were alive as of the last follow-up. In head and neck extramedullary plasmacytoma, radiation offers excellent local control with acceptable toxicities while also preserving organ function.

Background: Calcaneal fractures are relatively uncommon but account for a significant proportion of tarsal injuries. Often resulting from high-energy trauma, they carry a high risk of complications and remain a clinical challenge. Although open reduction and internal fixation (ORIF) is often successful, certain risk factors may predispose to failure and unexpected complications. Case Presentation: A 49-year-old female sustained a closed, displaced tongue-type calcaneal fracture after a fall from height and underwent acute screw fixation. At four weeks, radiographs revealed fracture recurrence and hardware failure, necessitating urgent reoperation with realignment and re-fixation, followed by a restrictive postoperative regimen. At 14 weeks post-reoperation, radiographs confirmed fracture healing. Upon completion of the treatment course, the patient was referred for continued physiotherapy to support ongoing functional recovery. Despite slight residual limitations, the patient reported minimal discomfort and regained mobility, reflected in an American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score of 81.Discussion: Calcaneal fractures are complex injuries with a high complication rate. Initial fixation of tongue-type calcaneal fractures may fail due to factors such as obesity, age, gender, surgical technique, or inadequate aftercare. A good functional outcome was ultimately achieved through timely reoperation, strict rehabilitation protocols, and close follow-up.Conclusion: This case underscores the importance of early surgical intervention, mitigating risk factors, and structured rehabilitation in managing complex calcaneal fractures. Risk factors should guide both surgical planning and aftercare. Early recognition of fixation failure and reoperation within four to six weeks can still result in favourable outcomes, even in high-risk patients.

Brucellosis is a zoonotic disease distributed across numerous countries and regions worldwide, presenting with diverse clinical manifestations. The most common complication is spondylitis, which is diagnosed primarily through imaging studies. However, in resource-limited areas, the imaging examinations necessary for diagnosing brucellosis-related spondylitis are often inaccessible. The objective of this study is to establish a simple and readily predictive score within brucellosis patients to screen for spinal involvement. We retrospectively collected patient data with brucellosis admitted to the Kashi Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2023, and randomly assigned them into a training cohort and an internal validation cohort. Data of brucellosis patients admitted to The third Affiliated Hospital of Sun Yat-sen University from January 2014 to December 2023 were collected for an external validation cohort. A diagnostic model was constructed by using a nomogram. Calibration plots, receiver operating characteristic curve, and decision curve analyses were employed to evaluate the model's calibration, accuracy, and clinical utility. This study included data from total of 784 patients, of which 210 were diagnosed with Brucella spondylitis. The data was divided into a training cohort (460 patients), an internal validation cohort (198 patients), and an external validation cohort (126 patients). The diagnostic model was formulated using six diagnostic factors: course of disease, age, back pain, joint pain, white blood cell count, and levels of C-reactive proteins. In our study, the AUC values of 0.93 (training), 0.87 (internal validation), and 0.77 (external validation) indicate that the model maintained excellent discriminative ability in the training and internal validation cohorts, and acceptable performance in the external cohort. Decision curve analyses graphically display the significant clinical utility and net benefit of a nomogram. The diagnostic model for Brucella spondylitis developed in this study has the potential to assist clinicians in resource-limited settings in achieving a rapid and effective diagnosis of the disease. Our model facilitates the identification of brucellosis-related spondylitis patients requiring extended treatment courses, thereby reducing misdiagnosis and missed diagnosis in resource-constrained areas where imaging examinations are difficult to access, and improving the efficiency of healthcare resource utilization.

Nutritional decline is a common challenge in head and neck cancer (HNC) patients undergoing concurrent chemoradiotherapy (CCRT). This study aimed to evaluate weekly trends in body weight and nutritional status to identify the timing and progression of malnutrition risk during treatment, thereby informing the timing of potential nutritional interventions. This observational longitudinal study enrolled 23 newly diagnosed HNC patients (87% male, median age 56.7years) receiving radiotherapy, with or without concurrent chemotherapy. Weekly weight measurements and Mini-Nutritional Assessment (MNA) scores were recorded throughout the 7-week treatment period. Nutritional counseling and general dietary advice were routinely provided as part of standard clinical care. Significant weight loss began in the 5th week of treatment, with an average total weight loss of 5.9% by the end of CCRT. MNA scores showed a clear decline from week 4 onward, and by week 7, most patients had entered the malnourished category. In parallel, 76% of patients required soft or liquid diets by the end of treatment, and the use of oral nutritional supplements increased from 10 to 96%. The results demonstrate that the risk of malnutrition increases rapidly during CCRT, particularly after the 4th week of treatment. Regular nutritional monitoring may be essential to detect early deterioration and guide the timing of nutritional support. Further studies are needed to evaluate the efficacy of structured nutritional interventions initiated early in the treatment course.

Background: COVID-19, a transmissible disease, has prompted global emergency responses and contributed to widespread outbreaks. Nutritional status is critical in infection defense, as malnutrition elevates risk and mortality. The Controlling Nutritional Status (CONUT) score assesses nutritional health and prognosis. This study investigates the association between the CONUT score and mortality in COVID-19 patients. Methods: Medical records of 502 COVID-19 patients over 18 at Sakarya University Hospital’s ICU from January to December 2021 were reviewed. Data included demographics, comorbidities, laboratory results, ICU interventions, and mortality. Nutritional status was assessed using the CONUT score based on serum albumin, cholesterol, and lymphocyte counts, ranging from 0 to 12, with classifications for normal to severe malnutrition. Chi-square tests were used to compare categorical variables between two groups. Results: The study comprised 502 COVID-19 patients, with a 34.6% survival rate. Mean age was 69.9±14.4 years. The length of ICU stay differed significantly between survivors and non-survivors (p = 0.013). Albumin levels were significantly lower in the non-survivors (p=0.002). Vasoactive infusion, inotropes, APACHE-II, and SOFA scores were significantly higher in non-survivors (p &amp;lt; 0.001). Mortality risk was significantly higher for vasopressor infusion, endotracheal intubation, and non-invasive ventilatory support (p&amp;lt;0.001). The CONUT score showed significant differences between survivors and non-survivors (p &amp;lt; 0.001), particularly between mild and moderate/severe malnutrition (p &amp;lt; 0.001). Conclusion: The CONUT score allows for early prognosis prediction in patients, enabling the treatment course to be tailored accordingly.