Correlation between Count Score and Cardiovascular Events in Maintenance Hemodialysis Patients

L. L, Y. Y, Luo T, F. M., Z. Y., Tian Lq, Wu Q, L. J., Liu F, Liu W, Yang L, X. J, Y. Y
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Abstract

Purpose: Evaluating the nutritional status of patients with Maintenance Hemodialysis (MHD) based on CONUT score to explore its relationship with Cardiovascular Disease (CVD) in MHD patients. Methods: Baseline data of new-coming MHD patients hospital hemodialysis center of our hospital undergoing hemodialysis treatment for the first time from January 1, 2014 to June 30, 2020 was collected. Cardiovascular events were used as the end point. Patients were divided into three groups according to CONUT score: normal nutrition group (CONUT score 0-1), mild malnutrition group (CONUT score 2-4) and moderate to severe malnutrition group (CONUT score ≥5), and the differences of clinical data and prognosis among the three groups were compared. The risk factors of cardiovascular events in MHD patients were determined by Logistic regression analysis, and the predictive ability of the risk factors was observed with Receiver Operating Characteristic (ROC) curve. Results: A total of 424 MHD patients were included. According to the CONUT score, 31 (7.3%) patients were in the normal nutrition group, 160 (37.7%) patients in the mild malnutrition group, and 233 (55.0%) patients in the moderate to severe malnutrition group. A total of 159 patients had cardiovascular events, including 3 cases (9.7%) in the normal nutrition group, 38 cases (23.8%) in the mild malnutrition group, and 118 cases (50.6%) in the moderate to severe malnutrition group. The worse the nutritional status of patients is, the higher the incidence rate of cardiovascular events is (P<0.05). Logistic regression analysis showed that CONUT score and age were independently correlated with cardiovascular events in MHD patients (P<0.05). ROC curve analysis showed that CONUT score and age predicted cardiovascular events in MHD patients with areas under the curve were 0.683 (95% CI: 0.632-0.735, P<0.001) and 0.702 (95% CI: 0.702), respectively. 0.652 -- 0.753, P<0.001), the optimal cut-off points were 4.5 (≥5 in combination) and 68.5, the sensitivity were 74.2% and 49.1%, and the specificity was 56.6% and 81.1%, respectively. Conclusion: There is a certain correlation between CONUT score the happening of cardiovascular events and MHD patients.
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维持性血液透析患者计数评分与心血管事件的相关性
目的:基于CONUT评分评估维持性血液透析(MHD)患者的营养状况,探讨其与MHD患者心血管疾病(CVD)的关系。方法:收集2014年1月1日至2020年6月30日我院血液透析中心首次接受血液透析治疗的新来MHD患者的基线数据。心血管事件被用作终点。根据CONUT评分将患者分为三组:营养正常组(CONUT评分0-1)、轻度营养不良组(CONUT评分2-4)和中度至重度营养不良组,CONUT评分≥5,比较三组患者的临床数据和预后差异。采用Logistic回归分析确定MHD患者心血管事件的危险因素,并用受试者操作特征(ROC)曲线观察危险因素的预测能力。结果:共纳入424名MHD患者。根据CONUT评分,31名(7.3%)患者属于正常营养组,160名(37.7%)患者属于轻度营养不良组,233名(55.0%)患者属于中度至重度营养不良组。共有159名患者发生心血管事件,其中正常营养组3例(9.7%),轻度营养不良组38例(23.8%),中度至重度营养不良组118例(50.6%)。患者的营养状况越差,心血管事件的发生率越高(P<0.05)。Logistic回归分析显示,CONUT评分和年龄与MHD患者的心血管事件独立相关(P<0.05),ROC曲线分析显示,曲线下区域的MHD患者CONUT评分与年龄预测的心血管事件分别为0.683(95%CI:0.632-0.735,P<0.001)和0.702(95%可信区间:0.702)。0.652-0.753,P<0.001),最佳分界点为4.5(联合≥5)和68.5,敏感性分别为74.2%和49.1%,特异性分别为56.6%和81.1%。结论:CONUT评分与MHD患者心血管事件的发生有一定的相关性。
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