Low Controlling Nutritional Status Research Articles

Association of Controlling Nutritional Status Score With Mortality in Patients With Chronic Limb-Threatening Ischemia Following Endovascular Revascularization

Chronic limb-threatening ischemia (CLTI) represents the severest manifestation of peripheral artery disease. Malnutrition is closely associated with poor clinical outcomes in patients with chronic diseases. The Controlling Nutritional Status (CONUT) score is a tool to evaluate the systemic inflammation and nutritional status. This study aimed to investigate the association of baseline CONUT score with mortality in patients with CLTI following endovascular revascularization. A single-center retrospective analysis of patients with CLTI undergoing endovascular revascularization between January 2015 and December 2022 was performed. Preoperative nutritional status was evaluated using CONUT score, which was calculated using the serum albumin concentration, total peripheral lymphocyte count, and total cholesterol concentration. A CONUT score ≥5 indicates moderate or severe malnutrition. The Kaplan-Meier and multivariate Cox proportional hazards regression were used for survival analysis and to evaluate the risk factors associated with mortality. Among 232 enrolled patients, 20.7% of patients had moderate or severe malnutrition defined by the CONUT score. During a median follow-up of 2.1 (interquartile ranges, 1.0-3.5) years, 87 (37.5%) patients died. The 3-year overall survival rate in patients with CLTI who underwent endovascular revascularization was 63.7%. The high CONUT (≥5) group had significantly worse 3-year overall survival (42.0% versus 68.8%, P=0.004) and limb salvage (73.3% versus 84.1%, P=0.005) rates than the low CONUT (<5) group. Multivariate analysis showed that high CONUT score was significantly associated with increased risk for mortality in patients with CLTI after endovascular revascularization (hazard ratio, 1.687; 95% confidence interval, 1.031-2.759; P=0.037). The present study indicated that moderate or severe malnutrition defined by the CONUT score was significantly associated with increased mortality in patients with CLTI following endovascular revascularization. Future study is required to evaluate the efficacy of nutritional intervention in these patients.

Effects of Pre-Transplant CONUT and Post-Transplant MRD on Prognosis of Patients with Multiple Myeloma after Auto-HSCT

To explore the effects of pre-transplant controlling nutritional status (CONUT) and post-transplant minimal residual disease (MRD) on prognosis of patients with multiple myeloma (MM) after autologous hematopoietic stem cell transplantation (auto-HSCT). The clinical data of 79 patients who received auto-HSCT from 2011 to 2020 in The First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The patients were divided into Low-CONUT group (n=62) and High-CONUT group (n=17) according to whether the CONUT score was less than 5. The differences in clinical features, hematopoietic reconstruction, adverse reactions, efficacy and survival between the two groups were compared. In addition, the prognostic risk factors were analyzed and verified by time-dependent ROC curve. The proportions of male patients and bone marrow plasma cells>30% at initial diagnosis in High-CONUT group were both higher than those in Low-CONUT group (both P <0.05). While, there were no significant differences in hematopoietic reconstruction and adverse reactions (>grade 2) between the two groups. The complete response (CR) rate and CR+very good partial response (VGPR) rate before transplantation in Low-CONUT group were both significantly higher than those in High-CONUT group (both P <0.05). After 3 months of transplantation, the CR+VGPR rate still remained an advantage in Low-CONUT group compared with High-CONUT group (P <0.01), but CR rate did not(P >0.05). The overall survival (OS) and progression-free survival (PFS) in Low-CONUT group were both superior to those in High-CONUT group (both P <0.05). Low CONUT score (0-4) before transplantation and negative MRD at 6 months after transplantation were favorable factors affecting OS and PFS (both P <0.05), while the International Myeloma Working Group (IMWG) high-risk at initial diagnosis and lactate dehydrogenase (LDH) level>250 U/L before transplantation were only risk factors for PFS (both P <0.05). Time-dependent ROC curve analysis showed that pre-transplant CONUT score and MRD status at 6 months after transplantation could independently or jointly predict 1- and 2-year OS and PFS, and the combined prediction was more effective. The combination of pre-transplant CONUT and post-transplant MRD can better predict the prognosis of MM patients.

Controlling Nutritional Status Score as a Predictor for Chronic Obstructive Pulmonary Disease Exacerbation Risk in Elderly Patients.

The Controlling Nutritional Status (CONUT) score is a simple screening tool able to assess poor nutritional status as well as to predict clinical adverse outcomes in different clinical settings. No data are available in older patients with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the CONUT score as a predictor of frequent exacerbations. We retrospectively enrolled 222 patients aged 65 years or older, classified in two groups according to the number of exacerbations (or hospitalizations because AECOPD) during the previous year. The two groups were further divided according to low (<5) or high (≥5) CONUT scores. A total of 67.2% of frequent exacerbators had a high CONUT score. These patients exhibited a significantly higher CAT score, lower FEV1 percentage value, and higher prevalence of severe GOLD stages compared to those with low CONUT. Multivariate analysis showed that a CONUT score ≥ 5 was the best independent predictor (OR 20.740, p < 0.001) of the occurrence of ≥2 exacerbations (or 1 hospitalization) during the previous year. The CONUT score seemed to have a high prognostic value for frequent exacerbations for COPD in older patients. The predictive role of different CONUT score cut-off values needs to be validated in larger COPD populations in future multi-center, prospective clinical studies.

CONUT score is associated with short-term prognosis in patients with severe acute pancreatitis: a propensity score matching cohort study.

The Controlling Nutritional Status (CONUT) score was designed to assess the immune-nutritional status in patients. This study aimed to investigate the role of the CONUT score in the short-term prognosis of severe acute pancreatitis. This was a retrospective cohort study. 488 patients with severe acute pancreatitis at the Department of Critical Care Medicine of the West China Hospital of Sichuan University (Chengdu, China) were enrolled in the study. Baseline data were collected from the West China Hospital of Sichuan University database. The primary outcome during follow-up was all-cause mortality. The secondary outcomes were 28 day mortality, renal insufficiency, length of stay (LOS) in the ICU, and length of stay (LOS) in the hospital. Patients were divided into two groups based on a median CONUT score of 7, and baseline differences between the two groups were eliminated by propensity matching. Univariate Cox regression analyses were performed to estimate the association between CONUT score and outcomes. The Kaplan-Meier method was used to estimate the survival rate of patients. CONUT score was an independent predictor of all-cause mortality (hazard ratio [HR]:2.093; 95%CI: 1.342-3.263; p < 0.001) and 28 day mortality (hazard ratio [HR]:1.813; 95%CI: 1.135-2.896; p < 0.013). CONUT score was not statistically significant in predicting the incidence of renal insufficiency. The high CONUT group had significantly higher all-cause mortality (p < 0.001), and 28 day mortality (p < 0.011) than the low CONUT group. The CONUT score is an independent predictor of short-term prognosis in patients with severe acute pancreatitis, and timely nutritional support is required to reduce mortality in patients with severe acute pancreatitis.

The CONUT score is prognostic in esophageal cancer treated with chemoradiotherapy.

Malnutrition is a frequent issue in esophageal cancer (EC). The Controlling Nutritional Status (CONUT) Score has been established as a prognostic indicator in EC patients who underwent surgery. We aimed to investigate the role of the CONUT Score in EC patients treated with chemoradiotherapy (CRT). The trial included 101 non-metastatic EC patients. Receiver operating characteristic (ROC) curve analyses were used to determine cut-off values for the CONUT Score and other indices. Cox regression analyses were performed to determine prognostic markers. Of 101 patients, 59.4% (n = 60) and 40.6% (n = 41) of patients were treated with CRT alone and CRT plus surgery, respectively. ROC curve analyses determined an optimal cut-off for CONUT Score in overall survival (OS), which was 3.5 (AUC = 0.63, CI 95%: 0.51-0.76, P = 0.05). The sensitivity and specificity of CONUT were 66% and 61%, respectively. Low CONUT (≤3.5) patients had significantly longer median OS than high CONUT (>3.5) patients (57.1 vs. 23 months; P = 0.009). Multivariate regression analysis revealed a CONUT Score hazard ratio (HR) of 1.96 for OS (CI 95%: 1.03-3.75, P = 0.04). The CONUT Score might be a useful prognostic tool in EC patients treated with CRT. Appropriate nutritional support might provide a better prognosis, which underlines the importance of multidisciplinary assessment of malnutrition in EC patients.

Malnutrition on admission increases the in-hospital mortality and length of stay in elder adults with acute ischemic stroke.

PurposeMalnutrition, as determined by the Controlling Nutritional Status (CONUT), has an effect on the 3‐month and long‐term prognosis of stroke patients. The association between malnutrition and in‐hospital mortality has not been well established. We aimed to investigate the relationship between the CONUT score on admission and in‐hospital mortality and length of stay (LOS) in elderly patients with acute ischemic stroke (AIS).MethodsThis study analyzed controls and patients with AIS. Malnutrition was determined using the CONUT score. A CONUT score of 5–12 was defined as undernutrition status. Based on the CONUT scores, the patients were divided into the low CONUT (0–4) and high CONUT (5–12) groups.ResultsIn total, 1079 participants were recruited, comprising 288 controls and 791 AIS patients. Among the 791 patients, 64 (8.1%) had malnutrition and 63 (7.9%) had an in‐hospital death. Compared to the controls, the AIS patients presented higher CONUT scores, higher proportion of in‐hospital mortality (8.0%), and longer length of stay. Malnutrition was independently associated with in‐hospital mortality in the AIS patients (adjusted odds ratio: 3.77, 95% confidence interval [CI]: 1.55–9.15; p = 0.003). The general linear models showed an association between the CONUT score and LOS (β = 0.574, 95% CI: 0.208–0.934; p = 0.002). Furthermore, the effect of the interaction between infection and nutrition status on in‐hospital mortality showed borderline statistical significance (p = 0.06).ConclusionsMalnutrition estimated by the CONUT score on admission can be a predictor of in‐hospital mortality and increased LOS in elderly AIS patients.

Association between baseline Controlling Nutritional Status score and clinical outcomes of patients with multiple myeloma.

The Controlling Nutritional Status (CONUT) score, a novel immuno-nutritional index, was reported as a predictor of overall survival (OS) in some tumors. We aimed to investigate the association between baseline CONUT Score and clinical outcomes in patients with multiple myeloma (MM). We performed a retrospective analysis of 245 patients with MM. The CONUT score was determined prior to therapy. Among the entire cohort, the complete remission rate was markedly higher in the low-CONUT (⩽ 3) group compared to the mid-CONUT (4-9) group or high-CONUT (> 9) group (44.1% vs 25.8%, P= 0.039; 44.1% vs 12.5%, P= 0.002). Patients with CONUT score > 9 had significant poor prognosis, and CONUT score ⩽ 3 group showed better survival outcome than other groups in OS (P< 0.001). Besides, we stratified the patients by combining International Staging System (ISS) stage and CONUT score in a model, and found that CONUT score could improve the prognostic impact of ISS stages on OS. In multivariate analysis, older age (⩾ 70 years) and a high CONUT score (⩾ 4) were independent prognostic risk factors for OS. The CONUT score was a predictor of OS in MM patients especially in cases with both low ISS staging and CONUT score. The baseline CONUT score may be an early and practical indicator of the efficacy of anti-myeloma treatment.

Controlling Nutritional Status (CONUT) Score Is a Prognostic Factor for Patients with Gastric Cancer Treated by Perioperative FLOT.

The aim of this study was to show that the Controlling Nutritional Status (CONUT) score has predictive value in gastric cancer (GC) patients treated with perioperative fluorouracil, leucovorin, oxaliplatin, or docetaxel (FLOT). A total of 161 GC patients treated with perioperative FLOT in our center were included in the study. The ideal cutoff values for the CONUT score were obtained using the receiver operating characteristic (ROC) curve analysis, and the patients were divided into low (≤3) and high (> 3) CONUT groups. The associations of CONUT with clinicopathological factors and survival were evaluated retrospectively. The median follow-up time was 11.2 months (2.3-32.3 months). The median overall survival (OS) for the entire population was 14.7 months (95% CI 13.5-15.9 months). Median OS was not reached in the low-CONUT group, but it was 14.2 months (95% CI 12.6-15.9) in the high-CONUT group and the difference was statistically significant (p = 0.002). The univariate Cox proportional hazards model revealed that OS was significantly associated with Eastern Cooperative Oncology Group (ECOG) status (p < 0.001), T4b stage (p 0.03), modified Glasgow Prognostic Scores (mGPS) (p 0.005), prognostic index (PI) (p 0.011), prognostic nutritional index (PNI) (p < 0.001), CONUT score (p 0.003), and mucinous histology (p 0.004). In multivariate analysis, ECOG performance status (p 0.029), PNI (p 0.001), CONUT score (p 0.040), and mucinous histology (p 0.001) were still identified as independent prognostic factors for OS. Our study demonstrated the prognostic significance of the CONUT score in GC patients treated with perioperative FLOT.

Controlling Nutritional Status score predict the individualized survival of patients with gastric cancer.

The present study aimed to determine the correlation between Controlling Nutritional Status (CONUT) score and prognosis in gastric cancer patients undergoing total gastrectomy. The clinical data of 245 gastric cancer patients who underwent total gastrectomy in Peking University, First Hospital between January1st 2005 and December 30th 2015 were retrospectively collected. According to the CONUT level, they were divided into high CONUT (>3) group and low CONUT (≤3) group. The relationship between CONUT and the disease-free survival (DFS) and overall survival (OS) were analyzed by statistical analysis. The results showed that the optimal cutoff value for CONUT to predict the 5-year survival was 3 and CONUT had a higher area under the ROC curve (AUC) for 5-year disease free survival (DFS) and overall survival (OS) prediction. Additionally, when age was considered as a stratified factor, univariate analyses demonstrated that high CONUT correlated with shorter DFS in non-elderly (<65) patients and shorter DFS and OS in elderly (≥65) patients. High CONUT was significantly correlated with older age, advanced TNM-stage, higher Ki-67 and pathological subtype. Patients with high pre-operative high CONUT levels should be given more observation and constant follow-up after surgery.

Prognostic significance of the Controlling Nutritional Status (CONUT) score in surgically treated breast cancer patients.

Breast cancer is one of the most common malignancy in women with high mortality rate. Given the growing evidence shows that immune-inflammatory system influences the survival of patients with cancer, we assessed the prognostic significance of the preoperative Controlling Nutritional Status (CONUT) score in patients with breast cancer who underwent surgery. We conducted a retrospective analysis of 1,367 breast cancer patients who underwent surgery between December 2010 and October 2012. All individual preoperative serum albumin concentration, total cholesterol concentration, and total peripheral lymphocyte count were counted to calculate CONUT. Higher CONUT score is in line with worse nutritional status. The optimal cut-off of CONUT score was set at 3 to categorize the investigated patients into two groups, namely a high- or low-CONUT score group. We adopted univariate and multivariate analyses (Cox proportional hazards regression model) statistical method. Patients in the high-CONUT score group had shorter overall survival (OS) and recurrence-free survival (RFS) in comparison with those in the low-CONUT score group, 66.43 vs. 69.30 months and 54.70 vs. 59.98 months respectively (all P value <0.05). Univariate and multivariate analyses revealed that the CONUT score was an independent predictor of OS (P=0.029 and 0.046, respectively) and RFS (P=0.001, P=0.013, respectively). The CONUT score was identified as an independent prognostic indicator in surgically treated breast cancer patients, indicating that, compared with the low CONUT score, a high CONUT score may lead to poorer prognosis.

Preoperative controlling nutritional status (CONUT) score as a novel immune-nutritional predictor of survival in non-metastatic clear cell renal cell carcinoma of ≤ 7cm on preoperative imaging.

This study aimed at investigating the prognostic value of Preoperative controlling nutritional status (CONUT) score in non-metastatic clear-cell renal cell carcinoma of ≤ 7cm on preoperative imaging. We retrospectively included 1046 among 1637 patients who underwent radical or partial nephrectomy for solid renal masses ≤ 7cm (2005-2014) after excluding other pathology, conditions affecting CONUT score components, metastasis, regional lymphadenopathy, positive margin, and follow-up < 12 months. We defined high and low CONUT according to cut-off of (2). Multivariate Cox-regression analysis was used to predict factors affecting recurrence and survival. Kaplan-Meier curve was used for survival analysis. The median age and follow-up were 56years and 63 months, respectively. 41 patients had recurrence (3.9%). CONUT was a predictor for recurrence-free, cancer-specific, and overall survival (HR 3.09, P = 0.003 and HR 4.66, P = 0.004 and HR 2.81, P = 0.003, respectively). A higher CONUT was significantly associated with worse 5years recurrence-free (88.2% vs. 97.1%), cancer-specific (96.2% vs. 98.8%) and overall (90.9% vs. 96.5%) survival (log-rank, P = < 0.001, P = 0.006 and P = < 0.001, respectively). The preoperative CONUT is an independent prognostic marker for survival after curative surgery for non-metastatic clear-cell renal cell carcinoma of ≤ 7cm on preoperative imaging.