Controlling Nutritional Status Score Predicts 1-Year Outcomes in Chronic Thromboembolic Pulmonary Hypertension.

Circulation reports Pub Date : 2024-08-29 eCollection Date: 2024-09-10 DOI:10.1253/circrep.CR-24-0023
Takeshi Adachi, Shiro Adachi, Yoshihisa Nakano, Itsumure Nishiyama, Miku Hirose, Toyoaki Murohara
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Abstract

Background: The prognosis for patients with chronic thromboembolic pulmonary hypertension (CTEPH) using their nutritional status has not been established. We investigated the relationship between the prognosis of patients with CTEPH and the Controlling Nutritional Status (CONUT) score, which is a nutritional assessment tool.

Methods and results: A total of 157 patients with CTEPH was enrolled in the study. The primary outcome was defined as the composite outcome of all-cause mortality and non-elective hospitalization due to heart failure. Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff CONUT score for predicting the 1-year rate of the primary outcome. Patients were divided into 2 groups according to the significant cutoff value and compared. Undernutrition was observed in 51.6% of patients. ROC analysis revealed a significant cutoff CONUT score of 3.5 (area under the curve=0.789). The incidence rate of the primary composite outcome was higher in the high CONUT group (score ≥4) than in the low CONUT group (score ≤3; 20% vs. 2.2%; P<0.001). Cox analysis revealed the CONUT score per point increase was an independent risk factor for the primary composite outcomes (hazard ratio 2.301; 95% confidence interval 1.081-4.895; P=0.031).

Conclusions: The CONUT score can predict the 1-year rate of all-cause death and non-elective hospitalization in patients with CTEPH.

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控制营养状况评分可预测慢性血栓栓塞性肺动脉高压的 1 年预后。
背景:慢性血栓栓塞性肺动脉高压(CTEPH)患者营养状况的预后尚未确定。我们研究了 CTEPH 患者的预后与营养评估工具--控制营养状况(CONUT)评分之间的关系:共有157名CTEPH患者参与研究。主要结果定义为全因死亡率和因心力衰竭非选择性住院的综合结果。采用接收者操作特征(ROC)曲线分析法确定预测主要结局 1 年发生率的 CONUT 临界值。根据显著的临界值将患者分为两组并进行比较。51.6%的患者存在营养不良。ROC分析显示,CONUT评分的重要临界值为3.5(曲线下面积=0.789)。高CONUT组(得分≥4)的主要综合结果发生率高于低CONUT组(得分≤3;20% vs. 2.2%;PC结论:CONUT评分可预测CTEPH患者1年的全因死亡率和非选择性住院率。
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