Table 1_Association between controlling nutritional status (CONUT) and all-cause mortality in elderly hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study.docx

ObjectiveNutritional status is a crucial modifiable factor that affects the prognosis of patients with chronic obstructive pulmonary disease (COPD). The CONUT score is a useful tool for comprehensively assessing nutritional status. This study aimed to investigate the relationship between the CONUT score at admission and the 3-year all-cause mortality rate among elderly patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
MethodsThis retrospective cohort study consecutively enrolled elderly patients hospitalized for AECOPD in the respiratory department of a tertiary hospital between 2013 and 2019. The CONUT score (based on serum albumin, total lymphocyte count, and total cholesterol) was calculated from initial admission laboratory results, categorizing patients into high-score (CONUT ≥ 5) and low-score (CONUT < 5) groups. The primary outcome was all-cause mortality over 3 years. Hazard ratios (HR) and their 95% confidence intervals (CI) were calculated using Cox proportional hazards regression models. Survival analysis was conducted using Kaplan-Meier curves, and dose-response relationships were explored using restricted cubic splines (RCS). Subgroup analyses were performed to assess the consistency of the association between a high CONUT score (≥5) and all-cause mortality.
ResultsThis study included 931 patients with a median follow-up of 30 months. Patients with a high CONUT score (≥5) had a significantly higher risk of 3-year all-cause mortality compared to those with lower scores (adjusted HR = 2.62, 95% CI: 1.69–4.08, P < 0.001). RCS analysis revealed a non-linear association between CONUT score and mortality (P for non-linearity = 0.003). Subgroup analyses confirmed consistent associations across age, sex, smoking status, admission type, and prior AECOPD history.
ConclusionsA higher CONUT score at admission is an independent risk factor for increased 3-year all-cause mortality in elderly hospitalized patients with AECOPD. This finding suggests that the CONUT score may serve as a simple and effective prognostic assessment tool for such high-risk patients, assisting in identifying individuals requiring enhanced nutritional support and management.