The prognostic impact of malnutrition on the outcomes of patients with vertebrobasilar artery occlusion following endovascular treatment

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-09-21 DOI:10.1016/j.jstrokecerebrovasdis.2024.108029

Song Pan , Yue-zhou Cao , Wen Sun , Zhenyu Jia , Lin-bo Zhao , Dezhi Liu , Hai-bin Shi , Sheng Liu

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引用次数: 0

Abstract

Background and purpose

Malnutrition is associated with poor outcomes in different diseases. Our aim was to investigate whether measures of malnutrition could be used to predict 90-day outcomes in patients with vertebrobasilar artery occlusion (VBAO) undergoing endovascular treatment (EVT).

Methods

We retrospectively analyzed patients with VBAO who received EVT at three comprehensive stroke centers. Malnutrition was assessed using the controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI). Primary outcome was good functional outcome defined as modified Rankin Scale (mRS) 0–3 measured at 90 days.

Results

A total of 285 patients were enrolled, of which 260 (91.22 %) met the requirements. According to the CONUT, GNRI, and PNI scores, the proportions of patients classified as moderately or severely malnourished were 7.3 %, 3.08 %, and 35 %, respectively. In the multivariate regression model after adjusting for potential confounders, malnutrition (severe risk versus normal nutritional status) was significantly associated with an increased risk of poor prognosis for CONUT scores (adjusted odds ratio [OR]14.91, 95 %CI, 1.69 - 131.71; P = 0.015), GNRI scores (adjusted [OR] 10.67, 1.17 - 96.93; P = 0.036) and PNI scores (adjusted [OR] 4.61, 2.28 - 9.31; P < 0.001). Similar results were obtained when malnutrition scores were analyzed as continuous variables. Adding the 3 malnutrition measures to the risk reclassification that included traditional risk factors significantly improved the predictive value of 3-month poor prognosis.

Conclusions

Our study showed that malnutrition may be associated with poor prognosis within 3 months of EVT in patients with VBAO.

查看原文本刊更多论文

营养不良对接受血管内治疗的椎基底动脉闭塞患者预后的影响。

背景和目的：营养不良与不同疾病的不良预后有关。我们的目的是研究营养不良指标是否可用于预测接受血管内治疗（EVT）的椎基底动脉闭塞（VBAO）患者的 90 天预后：我们对在三家综合卒中中心接受 EVT 的椎基底动脉闭塞患者进行了回顾性分析。营养不良采用控制营养状况（CONUT）评分、老年营养风险指数（GNRI）和预后营养指数（PNI）进行评估。主要结果是良好的功能预后，即在90天后测量的改良Rankin量表（mRS）0-3：共有 285 名患者入选，其中 260 人（91.22%）符合要求。根据 CONUT、GNRI 和 PNI 评分，被归类为中度或重度营养不良的患者比例分别为 7.3%、3.08% 和 35%。在调整潜在混杂因素后的多变量回归模型中，营养不良（严重风险与正常营养状况）与 CONUT 评分预后不良风险的增加显著相关（调整后的几率比 [OR]14.91，95%CI，1.69 - 131.71；P = 0.015）、GNRI 评分（调整后[OR]10.67，1.17 - 96.93；P =0.036）和 PNI 评分（调整后[OR]4.61，2.28 - 9.31；P< 0.001）。将营养不良评分作为连续变量进行分析时，也得到了类似的结果。在包括传统风险因素的风险再分类中加入3项营养不良测量指标，可显著提高3个月不良预后的预测价值：我们的研究表明，营养不良可能与VBAO患者EVT后3个月内的不良预后有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.