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

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.

The relationship of low-density lipoprotein cholesterol and all-cause or cardiovascular mortality in patients with type 2 diabetes: a retrospective study

“…There are a few general population-based studies that compare LDL-C levels and mortality risk between sexes. Both NHANES 1994-2014 data from the US ( Liu et al., 2021a ; Liu et al., 2021b ) and the Ibaraki Prefecture Health Study of Japan ( Noda et al, 2010 ) found that the lowest levels of LDL-C (<70 and <80 mg/dL, respectively) increased all-cause mortality risk in both men and women similar to the results of our study. In the Japanese study above ( Noda et al, 2010 ), higher, but not lower concentrations of LDL-C were associated with increased mortality risk from coronary heart disease for men, but not for women.…”

“…Each year’s lowest albumin and Hb were collected to calculate the mean of the annual mean of each to prevent overestimation of those values after replacement. Mean albumin levels were grouped into ≥3.5, 3.0−3.4, 2.5−2.9, and <2.5 g/dL ( Liu et al., 2021a ; Liu et al., 2021b ). Hypoglycemia was identified in patients with fasting or postprandial plasma or POC glucose values <70 mg/dL on any occasion during the study period ( Draznin et al, 2022 ).…”

Prognostic Potential of the Controlling Nutritional Status (CONUT) Score in Predicting All-Cause Mortality and Major Adverse Cardiovascular Events in Patients With Coronary Artery Disease: A Meta-Analysis

“…The controlling Nutritional Status (CONUT) score has been reported to be a simple and efficient screening tool for evaluating malnutrition status, especially for early detection and ongoing monitoring of nutritional status in hospitalized patients ( 16 ). Current studies suggest that CONUT is associated with short- and long-term prognoses in some diseases ( 9 , 14 , 15 , 17 ). The CONUT score is calculated based on the parameters of serum albumin, total cholesterol and, total lymphocyte levels, consisting of an immune-nutritional index reflecting protein/lipid metabolism and immunocompetence ( 16 ).…”

Nutritional Status Assessed with Objective Data Assessment Correlates with a High-Risk Foot in Patients with Type 2 Diabetes

“…A positive relationship between CONUT score and SGA was also reported previously [ 29 ]. In addition, previous studies showed that the CONUT score is a useful marker for mortality [ 30 , 31 ], healing of foot ulcers [ 32 , 33 ], and subclinical atherosclerosis [ 34 ]. In the present study, multivariate logistic regression analysis indicated that the CONUT score was significantly associated with a high-risk foot in the older group, with or without statin use.…”