目的:探索控制营养状况(Controlling Nutritional Status,CONUT)评分、WPCBAL评分、预后营养指数(Prognostic Nutritional Index,PNI)等3种预后评分系统对晚期肺癌患者生存时间的预测效能。方法:收集2018年12月—2021年12月在山东省第...目的:探索控制营养状况(Controlling Nutritional Status,CONUT)评分、WPCBAL评分、预后营养指数(Prognostic Nutritional Index,PNI)等3种预后评分系统对晚期肺癌患者生存时间的预测效能。方法:收集2018年12月—2021年12月在山东省第一医科大学附属肿瘤医院住院期间发生死亡,且具有评估所需全部数据的138例晚期肺癌患者的相关资料,进行回顾性分析。3个评分系统不同组别人群生存期差异的比较采用Log-rank检验,评估系统对终末期肺癌患者2周生存期的预测效能用受试者工作特征(ROC)曲线进行评价。结果:138例终末期肺癌患者的中位年龄为63.5岁,末次入院的中位生存时间为14 d,2周死亡率为51.4%。Log-rank检验结果显示,CONUT≥5分组的生存时间比CONUT<5分组更短,差异有统计学意义(11 d vs 16 d,P=0.046);WPCBAL≥5分组的生存时间比WPCBAL<5分组更短,差异有统计学意义(8 d vs 16 d,P=0.002)。ROC曲线显示,CONUT、WPCBAL对晚期肺癌患者2周生存状态的预测有一定价值,ROC曲线下面积分别为0.613、0.677。CONUT评分以5为截点时,预测晚期肺癌患者2周生存期的灵敏度、特异度分别为0.61、0.54;WPCBAL评分以5为截点时,预测晚期肺癌患者2周生存期的灵敏度、特异度分别为0.76、0.54。结论:CONUT评分、WPCBAL评分对预测晚期肺癌患者短期生存状态有一定价值,但特异度相对较低,仍需进一步研究。展开更多
目的评价术前CONUT评分在接受手术治疗的胃癌患者中的预后价值。方法计算机检索PubMed、Web of Science、Embase、Cochrane图书馆、中国期刊全文数据库(CNKI)、万方数据库等数据库,纳入关于术前CONUT评分与接受手术治疗胃癌患者预后的...目的评价术前CONUT评分在接受手术治疗的胃癌患者中的预后价值。方法计算机检索PubMed、Web of Science、Embase、Cochrane图书馆、中国期刊全文数据库(CNKI)、万方数据库等数据库,纳入关于术前CONUT评分与接受手术治疗胃癌患者预后的相关研究,检索时间为建库至2018年10月。按照纳入与排除标准筛选文献,提取数据并进行质量评价,采用Stata 12.0软件进行Meta分析。结果共纳入5篇英文文献,包含1822例Ⅰ~Ⅳ期胃癌患者。分析结果表明,术前CONUT评分与胃癌患者的总生存期(OS)显著相关,评分越高患者OS越短,差异有统计学意义(HR:1.71,95%CI:1.03~2.85,P=0.038)。亚组分析显示:在中国和截止值为3的研究中,术前CONUT评分与胃癌患者的OS明显缩短(中国,HR:1.44,95%CI:1.13~1.84,P=0.003;截止值为3,HR:3.27,95%CI:1.96~5.48,P<0.001)。但在日本和截止值不为3的研究中,术前CONUT评分与胃癌患者的OS无明显相关性(日本,HR:2.05,95%CI:0.68~6.18,P=0.203;截止值不为3,HR:1.16,95%CI:0.75~1.80,P=0.491)。结论术前CONUT评分与接受手术治疗胃癌患者的OS明显相关,可作为胃癌术后预后评估的潜在标记物。展开更多
Background:In-hospital mortality in patients with coronavirus disease 2019(COVID-19)is high.Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes.We aimed to determine the ...Background:In-hospital mortality in patients with coronavirus disease 2019(COVID-19)is high.Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes.We aimed to determine the usefulness of the CONtrolling NUTritional status(CONUT)index as a potential prognostic indicator of mortality in COVID-19 patients upon hospital admission.Methods:Our study design is of a retrospective observational study in a large cohort of COVID-19 patients.In addition to descriptive statistics,a Kaplan-Meier mortality analysis and a Cox regression were performed,as well as receiver operating curve(ROC).Results:From February 5,2020 to January 21,2021,there was a total of 2969 admissions for COVID-19 at our hospital,corresponding to 2844 patients.Overall,baseline(within 4 days of admission)CONUT index could be scored for 1627(57.2%)patients.Patients’age was 67.3±16.5 years and 44.9%were women.The CONUT severity distribution was:194(11.9%)normal(0-1);769(47.2%)light(2-4);585(35.9%)moderate(5-8);and 79(4.9%)severe(9-12).Mortality of 30 days after admission was 3.1%in patients with normal risk CONUT,9.0%light,22.7%moderate,and 40.5%in those with severe CONUT(P<0.05).An increased risk of death associated with a greater baseline CONUT stage was sustained in a multivariable Cox regression model(P<0.05).An increasing baseline CONUT stage was associated with a longer duration of admission,a greater requirement for the use of non-invasive and invasive mechanical ventilation,and other clinical outcomes(all P<0.05).The ROC of CONUT for mortality had an area under the curve(AUC)and 95%confidence interval of 0.711(0.676-0746).Conclusion:The CONUT index upon admission is potentially a reliable and independent prognostic indicator of mortality and length of hospitalization in COVID-19 patients.展开更多
文摘目的:探索控制营养状况(Controlling Nutritional Status,CONUT)评分、WPCBAL评分、预后营养指数(Prognostic Nutritional Index,PNI)等3种预后评分系统对晚期肺癌患者生存时间的预测效能。方法:收集2018年12月—2021年12月在山东省第一医科大学附属肿瘤医院住院期间发生死亡,且具有评估所需全部数据的138例晚期肺癌患者的相关资料,进行回顾性分析。3个评分系统不同组别人群生存期差异的比较采用Log-rank检验,评估系统对终末期肺癌患者2周生存期的预测效能用受试者工作特征(ROC)曲线进行评价。结果:138例终末期肺癌患者的中位年龄为63.5岁,末次入院的中位生存时间为14 d,2周死亡率为51.4%。Log-rank检验结果显示,CONUT≥5分组的生存时间比CONUT<5分组更短,差异有统计学意义(11 d vs 16 d,P=0.046);WPCBAL≥5分组的生存时间比WPCBAL<5分组更短,差异有统计学意义(8 d vs 16 d,P=0.002)。ROC曲线显示,CONUT、WPCBAL对晚期肺癌患者2周生存状态的预测有一定价值,ROC曲线下面积分别为0.613、0.677。CONUT评分以5为截点时,预测晚期肺癌患者2周生存期的灵敏度、特异度分别为0.61、0.54;WPCBAL评分以5为截点时,预测晚期肺癌患者2周生存期的灵敏度、特异度分别为0.76、0.54。结论:CONUT评分、WPCBAL评分对预测晚期肺癌患者短期生存状态有一定价值,但特异度相对较低,仍需进一步研究。
文摘目的探讨控制营养状态(controlling nutritional score,CONUT)评分对重症急性胰腺炎(severe acute pancreatitis,SAP)的预测价值。方法回顾性收集郑州大学第一附属医院2024年1月至2024年12月共426例急性胰腺炎患者,根据排除标准,筛出189例纳入研究。根据诊断标准分类为非重症急性胰腺炎(non-severe acute pancreatitis,NSAP)组和SAP组。分别比较各组患者之间的年龄、性别、基础疾病、生命体征、CONUT评分、急性胰腺炎严重程度床边指数(bedside index for severity in acute pancreatitis,BISAP)评分等一般资料,以及入院时血常规、血糖、肝肾功、血凝、淀粉酶、脂肪酶等实验室检测指标。采用二元Logistic回归分析影响急性胰腺炎严重程度的危险因素,并绘制各指标的受试者工作特征(ROC)曲线,分别检测其ROC曲线下面积(AUC)、敏感度、特异度及最佳预测临界值以评估预测价值。结果SAP组患者住院天数、呼吸、PCT、CRP、中性粒细胞绝对值、谷草转氨酶、谷氨酰转肽酶、凝血酶原时间、D二聚体、国际标准化比值、纤维蛋白原、FDP、CONUT评分、SIRS评分、BISAP评分均高于NSAP组,且差异具有统计学意义(P<0.05)。而NSAP组红细胞计数、血红蛋白、淋巴细胞绝对值、Ca 2+、白蛋白、总胆固醇、凝血酶原时间活动度、PNI评分高于SAP组(P<0.05)。二元Logistic回归分析显示,CONUT评分(OR=1.623,95%CI:1.048~2.512)、BISAP评分(OR=19.608,95%CI:6.585~58.387)为AP患者病情严重程度的独立危险因素。CONUT评分、BISAP评分及2项联合预测SAP的AUC分别为0.694、0.815及0.864。结论CONUT评分是SAP的早期独立危险因素,其联合BISAP评分对AP的病情严重程度具有更好的预测价值。
文摘目的评价术前CONUT评分在接受手术治疗的胃癌患者中的预后价值。方法计算机检索PubMed、Web of Science、Embase、Cochrane图书馆、中国期刊全文数据库(CNKI)、万方数据库等数据库,纳入关于术前CONUT评分与接受手术治疗胃癌患者预后的相关研究,检索时间为建库至2018年10月。按照纳入与排除标准筛选文献,提取数据并进行质量评价,采用Stata 12.0软件进行Meta分析。结果共纳入5篇英文文献,包含1822例Ⅰ~Ⅳ期胃癌患者。分析结果表明,术前CONUT评分与胃癌患者的总生存期(OS)显著相关,评分越高患者OS越短,差异有统计学意义(HR:1.71,95%CI:1.03~2.85,P=0.038)。亚组分析显示:在中国和截止值为3的研究中,术前CONUT评分与胃癌患者的OS明显缩短(中国,HR:1.44,95%CI:1.13~1.84,P=0.003;截止值为3,HR:3.27,95%CI:1.96~5.48,P<0.001)。但在日本和截止值不为3的研究中,术前CONUT评分与胃癌患者的OS无明显相关性(日本,HR:2.05,95%CI:0.68~6.18,P=0.203;截止值不为3,HR:1.16,95%CI:0.75~1.80,P=0.491)。结论术前CONUT评分与接受手术治疗胃癌患者的OS明显相关,可作为胃癌术后预后评估的潜在标记物。
基金The work is supported by a grant from the European Union's Horizon 2020 Research and Innovation Programme under Grant Agreement(No 101016216).
文摘Background:In-hospital mortality in patients with coronavirus disease 2019(COVID-19)is high.Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes.We aimed to determine the usefulness of the CONtrolling NUTritional status(CONUT)index as a potential prognostic indicator of mortality in COVID-19 patients upon hospital admission.Methods:Our study design is of a retrospective observational study in a large cohort of COVID-19 patients.In addition to descriptive statistics,a Kaplan-Meier mortality analysis and a Cox regression were performed,as well as receiver operating curve(ROC).Results:From February 5,2020 to January 21,2021,there was a total of 2969 admissions for COVID-19 at our hospital,corresponding to 2844 patients.Overall,baseline(within 4 days of admission)CONUT index could be scored for 1627(57.2%)patients.Patients’age was 67.3±16.5 years and 44.9%were women.The CONUT severity distribution was:194(11.9%)normal(0-1);769(47.2%)light(2-4);585(35.9%)moderate(5-8);and 79(4.9%)severe(9-12).Mortality of 30 days after admission was 3.1%in patients with normal risk CONUT,9.0%light,22.7%moderate,and 40.5%in those with severe CONUT(P<0.05).An increased risk of death associated with a greater baseline CONUT stage was sustained in a multivariable Cox regression model(P<0.05).An increasing baseline CONUT stage was associated with a longer duration of admission,a greater requirement for the use of non-invasive and invasive mechanical ventilation,and other clinical outcomes(all P<0.05).The ROC of CONUT for mortality had an area under the curve(AUC)and 95%confidence interval of 0.711(0.676-0746).Conclusion:The CONUT index upon admission is potentially a reliable and independent prognostic indicator of mortality and length of hospitalization in COVID-19 patients.
