Correlation of Controlling Nutritional Status Score and Systemic Immune-Inflammation Index With Frailty and Prognosis in Chronic Heart Failure Patients With Atrial Fibrillation.

Abstract

Objective: To explore the predictive value of the controlling nutritional status (CONUT) score combined with the systemic immune-inflammation index (SII) for frailty and prognosis in chronic heart failure (CHF) patients with atrial fibrillation (AF).

Methods: This retrospective study included 264 patients with CHF and AF who were admitted to and treated at the inpatient and outpatient departments of Nanjing Integrated Traditional Chinese and Western Medicine Hospital from January 2016 to July 2019. Follow-up ended upon patient death, with the final follow-up deadline set for September 2024. Binary logistic regression and Cox regression were used to identify factors influencing frailty and all-cause mortality. The cutoff values for the CONUT score and SII are determined by the ROC diagnostic threshold for mortality. Cutoff values for the CONUT score and SII were 6.5 and 990.2, respectively, categorizing patients into four groups: G1 (high CONUT ≥ 6.5 and high SII ≥ 990.2), G2 (high CONUT ≥ 6.5 and low SII < 990.2), G3 (low CONUT < 6.5 and high SII ≥ 990.2), and G4 (low CONUT < 6.5 and low SII < 990.2).

Results: Frailty was present in 165 patients (165/264). Multivariate logistic regression identified disease duration, CONUT score, and SII as significant factors for frailty. A positive correlation between CONUT and SII was observed (r = 0.648, p < 0.001). Cox regression analysis found smoking, CONUT, and SII as risk factors for mortality. Survival analysis showed lower survival rates in high CONUT and high SII groups (p < 0.001), with the G1 group having the lowest survival rate compared to G2, G3, and G4 (p < 0.001).

Conclusion: The CONUT score and SII are useful predictors of frailty and mortality in CHF patients with AF. Their combined use may improve the assessment of frailty and prognosis in this population.