Results
The study included 170 patients, comprising 105 (61.8%) men and 65
women (38.2%) with a mean age of 68.27±10.23 years. Median follow-up
period was 50 (interquartile range [IQR]: 41-60.25) months. Patients
were divided into two groups according to the CONUT score: (i) normal
nutrition (<2) and (ii) malnutrition (≥2). Clinical
characteristics of both groups are shown in Table 2. The mortality rate
and the neutrophil-to-lymphocyte ratio (NLR) were significantly higher
and the PNI scores were significantly lower in the malnutrition group
compared to the normal nutrition group (p =0.001,p <0.001, and p <0.001, respectively).
Table 3 presents a comparison of baseline hematological and biochemical
parameters of both groups. Significant differences were found between
the two groups with regard to serum hemoglobin, hematocrit, lymphocyte,
glucose, creatinine, albumin, total cholesterol, LDL, high-density
lipoprotein (HDL), thyroid stimulating hormone (TSH), and C-reactive
protein (CRP) levels.
In univariate logistic regression analysis, age, PNI, and CONUT score
were found to be independent predictors of all-cause death and stroke
(Odds Ratio [OR]: 1.061, 95% CI: 1.020-1.103, p =0.003, OR:
0.915, 95% CI: 0.864-0.970, p =0.003, OR: 1.134, 95% CI:
1.130-1.590, p =0.001). In multivariate logistic regression
analysis, age and CONUT score were independent predictors of all-cause
death and stroke, respectively (OR: 1.058, 95% CI: 1.013-1.105,p =0.011, OR: 1.318, 95% CI: 1.017-1.881, p =0.039) (Table
4).
At a cutoff value of 1.5, the CONUT score predicted long-term all-cause
death and stroke with a sensitivity of 66% and a specificity of 62%
(ROC area under curve [AUC]: 0.644, 95% CI: 0.541-0.747; Figure 1).
At a cutoff value of 46, PNI predicted long-term all-cause death and
stroke with a sensitivity of 65% and a specificity of 57% (AUC: 0.655,
95% CI: 0.560-0.749; Figure 2). A negative correlation was observed
between the CONUT score and PNI (r = -0.716, p <0.001;
Figure 3). Kaplan Meier analysis showed lower survival rates in the
malnutrition group (log rank = 9.36, p =0.002; Figure 4) and in
the group with a low PNI score (≤40) (log rank = 14.98,p <0.001; Figure 5).