scholarly journals Clinical significance of controlling nutritional status score (CONUT) in evaluating outcome of postoperative patients with gastric cancer

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Qi Xiao ◽  
Xiaoqing Li ◽  
Baojun Duan ◽  
Xiaofan Li ◽  
Sida Liu ◽  
...  

AbstractThe stomach is the main digestive organ in humans. Patients with gastric cancer often develop digestive problems, which result in poor nutrition. Nutritional status is closely related to postoperative complications and quality of life (QoL) in patients with gastric cancer. The controlling nutritional status (CONUT) score is a novel tool to evaluate the nutritional status of patients. However, the relationship of the CONUT score with postoperative complications, QoL, and psychological status in patients with gastric cancer has not been investigated. The present follow-up study was conducted in 106 patients who underwent radical gastrectomy in our hospital between 2014 and 2019. The CONUT score, postoperative complications, psychological status, postoperative QoL scores, and overall survival (OS) of patients with gastric cancer were collected, and the relationship between them was analyzed. A significant correlation was observed between the CONUT score and postoperative complications of gastric cancer (P < 0.001), especially anastomotic leakage (P = 0.037). The multivariate regression analysis exhibited that the CONUT score (P = 0.002) is an independent risk factor for postoperative complications. The CONUT score was correlated with the state anxiety questionnaire (S-AI) for evaluating psychological status (P = 0.032). However, further regression analysis exhibited that the CONUT score was not an independent risk factor for psychological status. Additionally, the CONUT score was associated with postoperative QoL. The multivariate regression analysis exhibited that the CONUT score was an independent risk factor for the global QoL (P = 0.048). Moreover, the efficiency of CONUT score, prognostic nutrition index, and serum albumin in evaluating complications, psychological status, and QoL was compared, and CONUT score was found to outperform the other measures (Area Under Curve, AUC = 0.7368). Furthermore, patients with high CONUT scores exhibited shorter OS than patients with low CONUT scores (P = 0.005). Additionally, the postoperative complications (HR 0.43, 95% CI 0.21–0.92, P = 0.028), pathological stage (HR 2.26, 95% CI 1.26–4.06, P = 0.006), and global QoL (HR 15.24, 95% CI 3.22–72.06, P = 0.001) were associated with OS. The CONUT score can be used to assess the nutritional status of patients undergoing gastric cancer surgery and is associated with the incidence of postoperative complications and QoL.

2018 ◽  
Vol 1 (3) ◽  
Author(s):  
Xinzheng Wang ◽  
Hongbin Luo

Objective This study aims to explore the relationship between sedentary behavior and the diabetes mellitus prevalence of middle-aged and elderly people. Methods  we conduct a questionnaire survey and physical examination for a total of 3,000 middle-aged and elderly people (≥45 years old) ,analysing by he software of  SPSS21.0 and Stata12.0. Results The logistic regression analysis shows that the risk of diabetes is 1.617 (95% CI, 0.762-1.789, P <0.05) at 2-4h, 4-6h, 6-8h, ≥8h, = 0.003), 1.235 (95% CI, 0.818-1.865, P = 0.034), 3.420 (95% CI, 2.241-5.218, P = 0.000), 5.014 (95% CI, 3.049-8.247, P = 0.000). With each additional one-hour sedentariness the risk of diabetes increases by 23% (OR1.23, 95% CI 1.18-1.29, p <0.0001). Conclusions The sedentary behavior is an independent risk factor for diabetes. The prevalence of diabetes is gradually increasing with the increase of sedentary time, which indicates the longer sedentary time, the higher prevalence of diabetes.


2020 ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  

Abstract Background: The Controlling Nutritional Status (CONUT) score is an emerging nutrition assessment tool that is very useful in patients with gastric cancer who usually experience weight loss and malnutrition. The aim of our study was to assess the predictive ability of the preoperative CONUT score for short-term prognosis in patients with gastric cancer undergoing laparoscopy-assisted gastrectomy.Methods: We retrospectively reviewed medical records of 309 patients who underwent curative laparoscopy-assisted gastrectomy. The patients were divided into two groups according to the optimal cutoff value of the CONUT score. The clinical association for the CONUT score, characteristics, and postoperative complications were evaluated and analyzed. The risk factors for complications were identified by univariate and multivariate analysis.Results: The preoperative CONUT score showed a good predictive ability for postoperative complications (AUC=0.718,Youden index=0.343),with an optimal cutoff value of 2.5. The patients with high CONUT scores had a higher incidence of overall complications (P<0.001) and mild complications (P<0.001). Univariate and multivariate analysis revealed that the CONUT score was independently associated with postoperative complications (P=0.012;OR=2.433;95%CI:1.218-4.862).Conclusions:The preoperative CONUT score was identified as a reliable nutritional assessment tool for predicting short-term prognosis in patients with gastric cancer after laparoscopy-assisted gastrectomy.


2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Jiajia Wang ◽  
Wenjuan Li ◽  
Chuan Wang ◽  
Lingshu Wang ◽  
Tianyi He ◽  
...  

Background. More and more studies focus on the relationship between the gastrointestinal microbiome and type 2 diabetes, but few of them have actually explored the relationship between enterotypes and type 2 diabetes. Materials and Methods. We enrolled 134 patients with type 2 diabetes and 37 nondiabetic controls. The anthropometric and clinical indices of each subject were measured. Fecal samples of each subject were also collected and were processed for 16S rDNA sequencing. Multiple logistic regression analysis was used to determine the associations of enterotypes with type 2 diabetes. Multiple linear regression analysis was used to explore the relationship between lipopolysaccharide levels and insulin sensitivity after adjusting for age, BMI, TG, HDL-C, DAO, and TNF-α. The correlation analysis between factors and microbiota was identified using Spearman correlation analysis. The correlation analysis between factors was identified using partial correlation analysis. Results. Gut microbiota in type 2 diabetes group exhibited lower bacterial diversity compared with nondiabetic controls. The fecal communities from all subjects clustered into two enterotypes distinguished by the levels of Bacteroides and Prevotella. Logistic regression analysis showed that the Bacteroides enterotype was an independent risk factor for type 2 diabetes by decreasing insulin sensitivity. The levels of lipopolysaccharide and tumor necrosis factor-alpha were higher in the Bacteroides enterotype compared to the Prevotella enterotype. Partial correlation analysis showed that lipopolysaccharide was closely associated with diamine oxidase, tumor necrosis factor-alpha, and Gutt insulin sensitivity index after adjusting for multiple covariates. Furthermore, the level of lipopolysaccharide was found to be an independent risk factor for insulin sensitivity. Conclusions. We identified two enterotypes, Bacteroides and Prevotella, among all subjects. Our results showed that the Bacteroides enterotype was an independent risk factor for type 2 diabetes, which was due to increased levels of lipopolysaccharide causing decreased insulin sensitivity.


2019 ◽  
Vol 11 (1) ◽  
pp. 55
Author(s):  
Hendry Sundah ◽  
Toar Mambu ◽  
Ferdinand Tjandra ◽  
Heber B. Sapan ◽  
Winfrid M. Sumanti

Abstract: Nutritional status is one of the factors that influence the metabolic and physiological conditions. Cancer patients, especially colorectal cancer (CRCA), will suffer from decreased nutritional status during their sickness. CONUT score is beneficial to evaluate the nutritional and immunity status of the patients and has been proved to correlate with post operative complications and length of stay. This study was aimed to evaluate the relationship between CONUT score and postoperative complications in CRCA patients. This was an analytical observational study with a cross sectional design. Subjects were 38 patients of CRCA that underwent operation and were admitted at Surgery Inpatients Installation of Prof. Dr. R. D. Kandou Hospital Manado. The result of logistic regression analysis indicated that there was a significant correlation between CONUT score and the risk of complication. The higher the CONUT score, the higher the risk of complication. The determination of complication diagnostic value based on CONUT score was obtained by using ROC curve. The ROC analysis showed that the AUC of CONUT score was 0.977 >0.700 and the cutoff point of CONUT score was 5.5. Patients with CONUT score >5.50 had a tendency to get postoperative complications with the sensitivity of 86.6%, specifity of 95.6%, and accuracy of 94.74%. Conclusion: CONUT score can be used as a screening method to predict the occurence of postoperative complications in CRCA patients.Kata kunci: colorectal cancer, CONUT score, postoperative complicationsAbstrak: Salah satu faktor yang memengaruhi keadaan metabolik dan fisiologik ialah status nutrisi. Penderita kanker terlebih kanker kolorektal (KKR) akan mengalami pengurangan nutrisi selama perjalanan penyakit. CONUT score bermanfaat untuk mengevaluasi status gizi dan imunitas pasien serta terbukti berkolerasi dengan komplikasi serta jumlah hari rawat di rumah sakit pasca pembedahan. Penelitian ini bertujuan untuk mengetahui hubungan CONUT score dengan komplikasi pasca pembedahan KKR. Jenis penelitian ialah analitik obser-vasional dengan desain potong lintang. Subyek penelitian ialah 38 pasien KKR yang menjalani operasi dirawat di Instalasi Rawat Inap Bedah RSUP Prof. Dr. R. D. Kandou Manado. Hasil analisis regresi logistik menyatakan terdapat hubungan yang sangat bermakna antara CONUT score dan kejadian komplikasi. Hubungan ini menyatakan bahwa makin tinggi CONUT score makin besar risiko terjadinya komplikasi. Penentuan nilai diagnostik kom-plikasi berdasarkan CONUT score diperoleh melalui kurva ROC. Berdasarkan analisis ROC diperoleh AUC CONUT score 0,977 >0,700. Hasil analisis ROC memperoleh titik potong CONUT score = 5,5. Pasien dengan CONUT score >5,50 memiliki kecenderungan mengalami komplikasi dengan sensitivitas 86,6%, spesifitas 95,6%, dan nilai akurasi 94,74%. Simpulan: CONUT score dapat digunakan sebagai metode skrining untuk memrediksi terjadinya komplikasi pasca pembedahan kanker kolorektal.Kata kunci: karsinoma kolorektal (KKR), CONUT score, komplikasi pasca pembedahan


2020 ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  

Abstract Background: The Controlling Nutritional Status (CONUT) score is an emerging nutrition assessment tool that is useful in gastric cancer (GC) patients. The aim of our study was to assess the predictive ability of the preoperative CONUT score for short-term outcomes in GC patients undergoing laparoscopy-assisted gastrectomy.Methods: We retrospectively reviewed the medical records of 309 patients who underwent curative laparoscopy-assisted gastrectomy. The patients were divided into two groups according to the optimal cut-off value of the CONUT score. The clinical characteristics and postoperative complications were evaluated and analysed in the low- and high-score groups. The risk factors for complications were identified by univariate and multivariate analysis.Results: The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC)=0.718, Youden index=0.343) compared with other indexes, with an optimal cut-off value of 2.5. Patients with high CONUT scores had a higher incidence of overall complications (P<0.001) and mild complications (P<0.001). Univariate and multivariate analyses revealed that the CONUT score was independently associated with postoperative complications (P=0.012; odds ratio (OR)=2.433; 95% confidence interval (CI): 1.218-4.862).Conclusions: The preoperative CONUT score is a reliable and useful nutritional assessment tool for predicting short-term outcomes in GC patients after laparoscopy-assisted gastrectomy.


2020 ◽  
Author(s):  
Ruoran Wang ◽  
Min He ◽  
Jirong Yue ◽  
Lang Bai ◽  
Dan Liu ◽  
...  

Abstract Background The coronavirus disease 2019 (COVID-19) pneumonia, outbreak in Wuhan, China, has led to a global pandemic. The high mortality of COVID-19 patients makes it significant to evaluate possible disease progression. This study was designed to explore the prognostic value of Controlling Nutritional Status (CONUT) score in patients with COVID-19. Methods Patients diagnosed with COVID-19 of a single center in Wuhan, China from January 2020 to February 2020 were enrolled in this study. Logistic regression analysis was performed to find independent risk factor of mortality. Receiver operating characteristics (ROC) curve was drawn to evaluate the prognostic value of CONUT score. Results Among 442 included patients, there were 79 non-survivors with mortality of 17.9%. Compared with survivors, the median age (p < 0.001) and male ratio (p = 0.042) were higher in non-survivors. Non-survivors had higher incidence of comorbidities including hypertension (p < 0.001), chronic lung disease (p = 0.001) and cardiovascular disease (p = 0.005). Complications such as respiratory failure(p < 0.001), acute kidney injury (AKI) (p < 0.001) occurred more frequently in non-survivors. Multivariate logistic regression analysis showed that CONUT (p = 0.002), lactate dehydrogenase (LDH) (p < 0.001), C-reactive protein (CRP) (p = 0.020) were risk factor of mortality in COVID-19 patients. Area under the ROC curve (AUC) of CONUT and Nutrition risk screening 2002 (NRS2002) score were 0.813 and 0.795, respectively. Comprised of CONUT, LDH, CRP, the constructed prognostic model had higher AUC of 0.923 (Z = 3.5210, p < 0.001). Conclusion CONUT is an independent risk factor of mortality in COVID-19 patients. Evaluating CONUT is beneficial for clinicians to predict the progression of COVID-19 patients and strengthen monitoring and management to improve prognosis.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  

Abstract Background An emerging prediction tool, the Controlling Nutritional Status (CONUT) score, has shown good assessment ability of postoperative outcomes in cancer patients. This study evaluated the role of the preoperative CONUT score regarding the short-term outcomes of gastric cancer (GC) after laparoscopic gastrectomy. Methods Three hundred and nine GC patients undergoing laparoscopic gastrectomy from January 2016 to June 2019 were analysed, retrospectively. The patients were divided into two groups according to the CONUT optimal cut-off value. Clinical characteristics and postoperative complications in the two groups were analysed and evaluated. Risk factors for complications were identified by univariate and multivariate analyses. Results A total of 309 patients underwent laparoscopic gastrectomy; 91 (29.4%) patients experienced postoperative complications. The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC) = 0.718, Youden index = 0.343) compared with other indices, with an optimal cut-off value of 2.5. Patients with high CONUT score had a significantly higher incidence of overall complications (P < 0.001). Age, haemoglobin, C-reactive protein, red blood cell levels, CONUT scores, surgical procedure type, T1, T4, N0 and N3 pathological TNM classification, and pathological stages of I and III were associated with postoperative complications (P < 0.05). Furthermore, the preoperative CONUT score was identified as an independent risk predictor of postoperative complications (P = 0.012; OR = 2.433; 95% CI, 1.218-4.862) after multivariate analysis. Conclusions The preoperative CONUT score is a practical nutritional assessment for predicting short-term outcomes in GC patients after laparoscopy-assisted gastrectomy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feng Sun ◽  
Chen Zhang ◽  
Zhijian Liu ◽  
Shichao Ai ◽  
Wenxian Guan ◽  
...  

Abstract Background It is well established that the controlling nutritional status (CONUT) score was correlated with long-term outcomes in gastric cancer (GC), but the significance of CONUT for postoperative short-term outcomes remains unclear. The study aimed to characterize the relationship between CONUT and short-term complications following gastrectomy of GC. Methods We collected data on 1479 consecutive GC patients at Nanjing Drum Tower Hospital between January 2016 and December 2018. Univariate and multivariate analyses of predictive factors for postoperative complications were performed. The cutoff value of the CONUT score was determined by Youden index. Results Among all of the patients, 431 (29.3%) patients encountered postoperative complications. Multivariate analyses identified CONUT was an independent predictor for postoperative short-term complications (OR 1.156; 95% CI 1.077–1.240; P < 0.001). Subgroup analysis elucidated that CONUT was related to postoperative complications both in early gastric cancer and advanced gastric cancer. We further explored that patients with high CONUT score had prolonged hospital stay (12.3 ± 6.0 vs 11.1 ± 4.6, P < 0.001) and more total hospital charges (7.6 ± 2.4 vs 7.1 ± 1.6, P < 0.001). Conclusions The present study demonstrated that the preoperative CONUT was an independent predictor for short-term complications following gastrectomy of GC.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Peng ◽  
Minghong Yao ◽  
Kang Zou ◽  
Chuan Li ◽  
Tianfu Wen ◽  
...  

Abstract Background The controlling nutritional status (CONUT) score has been widely used to evaluate the nutritional and immunological status. Clinical value of postoperative CONUT (PoCONUT) score in hepatocellular carcinoma (HCC) remains unknown. This study assessed whether PoCONUT score could serve as a useful predictor of survival for patients with small HCC. Methods 547 consecutive patients with small HCC who underwent liver resection between February 2007 and December 2015 were included in this retrospective case-control study. Patients were categorized into two groups: low PoCONUT group (PoCONUT score ≤ 2, n = 382) and high PoCONUT group (PoCONUT score ≥ 3, n = 165). Propensity score matching (PSM) analysis was applied to balance the bias in baseline characteristics. A cumulative survival curve was established by the Kaplan–Meier method, and differences in OS and RFS among CONUT score groups were determined by the log rank test. Cox proportional hazard regression analysis was used to evaluate the association of PoCONUT score and overall survival (OS) and recurrence-free survival (RFS), with calculation of hazard ratios (HRs) and 95 % confidence intervals (95 % CIs). Results Cox proportional hazard regression analysis suggested that the PoCONUT score was an independent risk factor for both OS and RFS in patients with small HCC before and after PSM. Conclusions High PoCONUT score helps to predict worse OS and RFS in patients with small HCC who underwent liver resection.


2020 ◽  
Author(s):  
Yun Qian ◽  
Huaying Liu ◽  
Junhai Pan ◽  
Weihua Yu ◽  
Jiemin Lv ◽  
...  

Abstract Background: As an emerging prediction tool, the Controlling Nutritional Status (CONUT) score has shown good assessment ability of postoperative outcomes in cancer patients. This study assessed the role of the preoperative CONUT score in short-term outcomes of gastric cancer (GC) after laparoscopic gastrectomy.Methods: Three hundred and nine patients undergoing laparoscopic gastrectomy from January 2016 to June 2019 were analyzed, retrospectively. GC patients were divided into two groups according to the optimal cut-off value of the CONUT. The clinical characteristics and postoperative complications were analyzed and evaluated in two groups. The risk factors of complications were identified by univariate and multivariate analysis.Results: 309 patients received laparoscopic gastrectomy, and 91 (29.4%) patients suffered from postoperative complications. The preoperative CONUT score showed a good predictive ability for postoperative complications (area under the curve (AUC)=0.718, Youden index=0.343) compared with other indexes, with an optimal cut-off value of 2.5. Patients with high CONUT score suffered a significantly higher incidence of overall complications (P<0.001). Age, haemoglobin level, C-reactive protein level, red blood cell level, CONUT scores, type of operative procedure, pathological TNM classification of T1, T4, N0, and N3, and pathological stage of I and III were associated with postoperative complications (P<0.05). Furthermore, preoperative CONUT score was identified as an independent risk predictor of postoperative complications (P=0.012; OR=2.433; 95% CI: 1.218-4.862) after multivariate analysis.Conclusions: The preoperative CONUT score is a practical nutritional assessment for predicting short-term outcomes in patients with gastric cancer after laparoscopy-assisted gastrectomy.


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