Musculo-Immuno-Nutritional Score as a Prognostic Marker in Patients with Interstitial Pneumonia Awaiting Lung Transplantation.

Abstract

Purpose: This study evaluated the prognostic significance of the controlling nutritional status/creatine kinase score (CNKS), a composite index derived from the controlling nutritional status (CONUT) score and creatine kinase (CK) level, in patients with interstitial pneumonia awaiting lung transplantation (LT).

Methods: We retrospectively analyzed 202 patients with interstitial pneumonia who were registered for LT between January 2014 and July 2023. CNKS was calculated using CK levels and the CONUT (derived from albumin level, lymphocyte count, and cholesterol level).

Results: Among the 202 patients, 130 (64.4%) were alive, while 72 (35.6%) had died at the time of analysis. Among the surviving patients, 79 (39.1%) underwent cadaveric LT, and 51 (25.2%) remained on the waiting list. A high CNKS (n = 72 [35.6%]) was significantly associated with a lower body mass index (P <0.001), a shorter 6-minute walk distance (P <0.001), and lower forced vital capacity (P = 0.006) compared with a low CNKS (n = 130 [64.4%]). The results of the multivariate analysis showed that CNKS was a significant independent prognostic factor for survival during the waiting period (P = 0.031).

Conclusion: CNKS represents a promising prognostic marker, potentially useful in selecting lung transplant candidates and guiding nutritional and rehabilitative interventions during the pretransplant period.