Relationship between Nutritional Scales and Prognosis in Elderly Patients after Acute Ischemic Stroke: Comparison of Controlling Nutritional Status Score and Geriatric Nutritional Risk Index
Relationship between Nutritional Scales and Prognosis in Elderly Patients after Acute Ischemic Stroke: Comparison of Controlling Nutritional Status Score and Geriatric Nutritional Risk Index
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DOI：
10.1159/000515212
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发表时间：
2021-05-19
影响因子：
3.9
通讯作者：
Nakajima, Hideto
中科院分区：
文献类型：
--
作者：
Akimoto, Takayoshi;Hara, Makoto;Nakajima, Hideto
背景/目的：营养不良在急性缺血性卒中（AIS）患者中很常见，并预示着不良的临床结局。我们评估了AIS后营养不良与预后之间的关系。方法：我们回顾性评估了年龄≥ 65岁的连续住院AIS患者。AIS后患者预后不良定义为出院时改良兰金量表（mRS）评分>= 3分。根据营养不良的程度和风险评估营养状况，营养不良的程度和风险由控制营养状况（UND-CONUT）和老年营养风险指数（GNRI）评分确定。结果：218例患者（男性，62.8%;中位年龄，77岁），81例预后不良。UND-CONUT和EST-GNRI评分之间存在显著相关性（p < 0.001，r = 0.433）。根据UND-CONUT（p = 0.003），预后不良的患者显示出显著的营养不良，但根据UND-GNRI（p = 0.218）则没有。基于UND-CONUT的营养不良患者的结局较差：出院时mRS评分较高，mRS评分>= 2和>= 3的百分比较高，与肺炎相关的并发症较多。根据EST-GNRI，有营养不良风险和无营养不良风险的病例之间没有显著差异。结论：UND-CONUT对老年AIS患者出院时预后的预测价值高于UND-GNRI。
Background/Aims: Undernutrition is common in patients after acute ischemic stroke (AIS) and predicts poor clinical outcomes. We assessed the relationship between undernutrition and prognosis after AIS. Methods: We retrospectively assessed consecutively hospitalized AIS patients aged >= 65 years. A poor prognosis for patients after AIS was defined as a modified Rankin Scale (mRS) score of >= 3 at discharge. Nutritional status was evaluated based on the degree and risk of undernutrition as determined by the Controlling Nutritional Status (UND-CONUT) and Geriatric Nutritional Risk Index (UNR-GNRI) scores. Results: Among 218 patients (male, 62.8%; median age, 77 years), 81 had a poor prognosis. A significant correlation was found between UND-CONUT and UNR-GNRI scores (p < 0.001, r = 0.433). Patients with a poor prognosis showed significant undernutrition based on UND-CONUT (p = 0.003) but not on UNR-GNRI (p = 0.218). Patients with undernutrition based on UND-CONUT showed poor outcomes: higher mRS scores at discharge, higher percentages of mRS scores of >= 2 and >= 3, and more complications associated with pneumonia. No significant differences were seen between cases with and without undernutrition risk based on UNR-GNRI. Conclusion: UND-CONUT appeared to be more useful than UNR-GNRI for predicting the prognosis of elderly patients with AIS at discharge.