Controlling Nutritional Status (CONUT) score predicts worse outcomes in Chinese cardiac surgery patients

Background: & Aims: Nutritional and immunological status was assessed by the Controlling Nutritional Status (CONUT) score calculated from serum albumin, total cholesterol and total peripheral lymphocyte count. The aim of this study was to determine the prognostic impact of the CONUT score on patients underwent cardiac surgery. Methods: : This is a single-center retrospective observational study in cardiac surgery patients. Baseline characteristics, comorbidities, and laboratory data were collected. The primary outcome was all-cause mortality. The secondary outcomes were postoperative complications including acute kidney injury (AKI), transient ischemic attack or stroke, reoperation for bleeding. Univariate and multivariate Cox regression were performed to investigate the association between confounding factors and outcomes. The cut-off value of CONUT score was accessed by the receiving operating characteristic curve. We used the Kaplan-Meier curve to compare the outcomes according to the cut-off CONUT score. The area under the curve (AUC) was used to test discriminative power of CONUT score and relevant clinical parameters. Results: : A total of 408 patients were enrolled in this study. During a median follow-up period of 72.12 months, 28 (6.9%) patients died and 43 (10.5%) patients occurred postoperative complications. The rate of all-cause mortality and postoperative complications was higher in the high CONUT score (>3) group than in the low CONUT score group ( p=0.002, p=0.02 ). High CONUT score (hazard ratio [HR] =2.367, 95% confidence interval [CI]=1.072 to 5.266, P=0.033) was an independent predictor of all-cause mortality. The AUC of the joint probability of CONUT score, age, and hypertension in predicting all-cause mortality was 0.744 (95% CI: 0.687–0.775). The high CONUT score was still an independent risk factor of secondary outcomes (HR=2.316, 95%CI=1.122 to 4.780, P=0.023). Conclusion: The CONUT score was independently associated with all-cause mortality and postoperative complications in patients underwent cardiac surgery.