Journal
NUTRIENTS
Volume 14, Issue 7, Pages -Publisher
MDPI
DOI: 10.3390/nu14071337
Keywords
malnutrition; immunity; acute ischemic stroke; recurrent ischemic stroke; long-term prognosis; the controlling nutritional status score; the prognostic nutritional index score
Categories
Funding
- National Natural Science Foundation of China [81925031, 81820108026, 81872549, 82003389]
- Science and Technology Program of Guangzhou [202007030001]
- Guangzhou Municipal Science and Technology Project [201904010314]
- Key-Area Research and Development Program of Guangdong Province [2018B030340001]
- Youth Program of National Natural Science Foundation of China [81801229]
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This study demonstrates that CONUT and PNI are promising screening indicators to identify AIS patients with impaired immune-nutritional status who are at higher risk of long-term RIS and MACEs.
Background: The controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) score were designed as indicators of patients' immune-nutritional status. This study aimed to investigate the prognostic impact of the CONUT and PNI scores on long-term recurrent ischemic stroke (RIS) and adverse outcomes for adults with acute ischemic stroke (AIS). Methods: This retrospective study enrolled 991 AIS patients. Multivariable Cox regression models were used to assess the relationships of the malnutritional indices and RIS and major cardiovascular events (MACEs). Results: During a median follow-up at 44 months (IQR 39-49 months), 203 (19.2%) patients had RIS and 261 (26.3%) had MACEs. Compared with normal nutritional status, moderate to severe malnutrition was significantly related to an increased risk of RIS in the CONUT score (adjusted hazard ratio (HR) 3.472, 95% confidence interval (CI) 2.223-5.432, p < 0.001). A higher PNI value tertile (tertile two, adjusted HR 0.295, 95% CI 0.202-0.430; tertile three, adjusted HR 0.445, 95% CI 0.308-0.632, all p < 0.001) was related to a lower risk of RIS. Similar results were found for MACEs. The PNI exhibited nonlinear association with the RIS and both two malnutritional indices improved the model's discrimination when added to the model with other clinical risk factors. Conclusions: This study demonstrated that the CONUT and PNI are promising, straightforward screening indicators to identify AIS patients with impaired immune-nutritional status at higher risk of long-term RIS and MACEs.
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