Prospective investigation of the Controlling Nutritional Status (CONUT) score and clinical course of patients with COPD

Abstract

Background

The Controlling Nutritional Status (CONUT) score evaluates nutritional status based on the following three indices: serum albumin, total cholesterol, and peripheral blood lymphocyte count. However, the impact of the CONUT score on the clinical course of patients with chronic obstructive pulmonary disease (COPD) has not been fully investigated.

Methods

We conducted an observational study of patients with stable COPD attending our hospital. At enrollment, patients with CONUT scores of ≤1 and ≥ 2 were assigned to the normal and malnourished groups, respectively. The patients’ clinical course for up to 5 years were prospectively analyzed.

Results

We enrolled 210 COPD patients (mean age: 70.5 years, 196 men). Seventy-two patients (34.3 %) had malnutrition with a CONUT score of ≥2. These patients were significantly older, had a lower body mass index (BMI), and had lower levels of pulmonary function than those with a normal CONUT score. There were no significant differences between the two groups in sex, smoking history, previous exacerbations, asthma and COPD overlap (ACO) status, COPD Assessment Test score, or emphysema severity at enrollment. The malnourished group had significantly more COPD exacerbations during the observation period than the normal group. After adjusting for age, BMI, ACO status, COPD severity, and emphysema severity by multivariate logistic regression analysis, the presence of malnutrition with a CONUT score of ≥2 was an independent risk factor for COPD exacerbation.

Conclusion

The assessment of nutritional status by using the CONUT score may be useful in assessing the risk of exacerbation in patients with stable COPD.