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A prospective epidemiological analysis of controlling nutritional status score with the poor functional outcomes in Chinese patients with haemorrhagic stroke

Published online by Cambridge University Press:  19 August 2021

Bei Lei Zhu ,
Yan Zhi Wu ,
Zhong Ming Cai ,
Cheng-Wei Liao ,
Le Qiu Sun ,
Zhi Peng Liu ,
Hao Man Chen ,
Xue Rong Huang ,
Ren Qian Feng  and
Sheng Lie Ye
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Bei Lei Zhu
Affiliation:
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Yan Zhi Wu
Affiliation:
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Zhong Ming Cai
Affiliation:
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Cheng-Wei Liao
Affiliation:
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Le Qiu Sun
Affiliation:
Department of Neurology, Wenzhou Medical Univerisity Affiliated Yueqing Hospital, Wenzhou, Zhejiang, People’s Republic of China
Zhi Peng Liu
Affiliation:
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Hao Man Chen
Affiliation:
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Xue Rong Huang
Affiliation:
Department of Neurology, Ruian People’s Hospital, Wenzhou, Zhejiang, People’s Republic of China
Ren Qian Feng
Affiliation:
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Sheng Lie Ye
Affiliation:
Department of First Clinical Medical School, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Qun Li Lin
Affiliation:
Department of Neurology, Yongjia People’s Hospital, Wenzhou, Zhejiang, People’s Republic of China
Xu Dong Zhou
Affiliation:
Department of Neurology, Pingyang People’s Hospital, Wenzhou, Zhejiang, People’s Republic of China
Liang Wang
Affiliation:
Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
Man Man Zhang*
Affiliation:
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
Bo Yang*
Affiliation:
School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
*
*Corresponding author: Man Man Zhang, email: zhangmanman@wmu.edu.cn; Bo Yang, email: ybzju@zju.edu.cn
*Corresponding author: Man Man Zhang, email: zhangmanman@wmu.edu.cn; Bo Yang, email: ybzju@zju.edu.cn
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Abstract

Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.

Keywords

Controlling nutritional status scoreHaemorrhagic strokeNutrition screeningModified Rankin scaleClinical nutrition
Type
Research Article
Information
British Journal of Nutrition , Volume 128 , Issue 2 , 28 July 2022 , pp. 192 - 199
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

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Footnotes

†

These authors contributed equally to this work.

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