The Relationship of CONUT Score and Blood Urea Nitrogen/Albumin Ratio With Survival and Neurological Outcome in Patients With Acute Ischemic Stroke Followed in Neurology Intensive Care

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2025-05-26 DOI:10.1155/ane/8005012

Eren Mingsar, Zeynep Tanrıverdi, Mensure Çakırgöz, Dilan Düztaş, Hatice Sevil

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Abstract

Background: Malnutrition is a frequent but underrecognized factor influencing prognosis in acute ischemic stroke (AIS) patients, particularly in intensive care settings. This study is aimed at evaluating the prognostic value of the controlling nutritional status (CONUT) score and the blood urea nitrogen/albumin (BUN/ALB) ratio on neurological outcomes and in-hospital mortality.

Methods: This retrospective cohort study included 208 AIS patients admitted to a neurology intensive care unit between 2020 and 2022. Nutritional status was assessed within 24–48 h using the CONUT score, calculated from serum albumin, total lymphocyte count, and cholesterol. The BUN/ALB ratio was used as an additional marker. Neurological outcomes were evaluated on day 60 using the modified Rankin Scale (mRS). Statistical analyses included univariate and multivariate logistic regression, Cox regression, ROC curve analysis, and Kaplan–Meier survival analysis.

Results: Higher CONUT scores and BUN/ALB ratios were significantly associated with poor neurological outcomes and increased in-hospital mortality. In multivariate analysis, both markers remained independent predictors of poor prognosis (CONUT OR = 3.8, p = 0.013; BUN/ALB OR = 7.4, p = 0.014). ROC analysis showed strong predictive value, especially for the CONUT score (AUC = 0.898 for progression; AUC = 0.860 for mortality).

Conclusion: Early assessment of nutritional status using CONUT and BUN/ALB ratio may help identify AIS patients at higher risk of poor outcomes. These cost-effective and easily obtainable markers can support clinical decision-making and improve prognostic accuracy in intensive care management.

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神经内科重症监护急性缺血性脑卒中患者CONUT评分和血尿素氮/白蛋白比值与生存和神经预后的关系

背景：营养不良是影响急性缺血性卒中（AIS）患者预后的一个常见但未被充分认识的因素，特别是在重症监护环境中。本研究旨在评估控制营养状况（CONUT）评分和血液尿素氮/白蛋白（BUN/ALB）比值对神经预后和住院死亡率的预后价值。方法：这项回顾性队列研究纳入了2020年至2022年间入住神经内科重症监护病房的208名AIS患者。使用CONUT评分评估24-48小时内的营养状况，该评分由血清白蛋白、总淋巴细胞计数和胆固醇计算。BUN/ALB比率作为附加标记物。在第60天使用改良Rankin量表（mRS）评估神经系统预后。统计分析包括单因素和多因素logistic回归、Cox回归、ROC曲线分析和Kaplan-Meier生存分析。结果：较高的CONUT评分和BUN/ALB比值与较差的神经预后和较高的住院死亡率显著相关。在多变量分析中，这两个指标仍然是预后不良的独立预测因子(CONUT OR = 3.8, p = 0.013；BUN/ALB OR = 7.4, p = 0.014)。ROC分析显示较强的预测价值，特别是CONUT评分(AUC = 0.898；死亡率AUC = 0.860)。结论：使用CONUT和BUN/ALB比值早期评估营养状况可能有助于识别预后不良风险较高的AIS患者。这些具有成本效益且易于获得的标志物可以支持临床决策并提高重症监护管理的预后准确性。

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

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.