Controlling the nutritional status score: a new tool for predicting postoperative mortality in patients with infrarenal abdominal aortic aneurysm treated with endovascular aneurysm repair

Sheng-Lin Ye; Tian-Ze Xu; Chuang Wang; Kang Han; Xu-Dong Jiang; Tao Tang; Bin Song; Xiao-Long Du; Nan Hu; Xiao-Qiang Li

doi:10.3389/fnut.2024.1351797

Controlling the nutritional status score: a new tool for predicting postoperative mortality in patients with infrarenal abdominal aortic aneurysm treated with endovascular aneurysm repair

Front Nutr. 2024 May 1:11:1351797. doi: 10.3389/fnut.2024.1351797. eCollection 2024.

Authors

Sheng-Lin Ye^#¹, Tian-Ze Xu^#¹, Chuang Wang^#¹, Kang Han¹, Xu-Dong Jiang¹, Tao Tang¹, Bin Song¹, Xiao-Long Du¹, Nan Hu¹, Xiao-Qiang Li¹

Affiliation

¹ Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.

^# Contributed equally.

Abstract

Background: AAA is a fatal condition that commonly occurs during vascular surgery. Nutritional status exerts a significant influence on the prognosis of various pathological conditions Scores from the CONUT screening tool have been shown to predict outcomes of certain malignancies and chronic diseases. However, the ramifications of nutritional status on AAA patients undergoing EVAR have not been elucidated in prior studies. In this study, we aimed to elucidate the correlation between CONUT scores and postoperative prognostic outcomes in patients with AAA undergoing EVAR.

Methods: This was a retrospective review of 177 AAA patients treated with EVAR from June 2018 to November 2019 in a single center. Patient characteristics, CONUT scores, and postoperative status were collected. These patients were stratified into groups A and B according to CONUT scores. Subsequently, a comparative analysis of the baseline characteristics between the two cohorts was conducted. Cox proportional hazards and logistic regression analyses were employed to identify the autonomous predictors of mid-term mortality and complications, respectively.

Results: Compared with group A, patients in group B had higher midterm mortality (p < 0.001). Univariate analysis showed that CONUT scores; respiratory diseases; stent types; preoperative Hb, CRP, PT, and Fb levels were risk factors for death. Multivariate analysis confirmed that CONUT score [HR, 1.276; 95% CI, 1.029-1.584; p = 0.027] was an independent risk factor for mortality. Logistic regression analysis showed that prior arterial disease, smoking, and D-dimer levels were risk factors, although multivariate analysis showed smoking (OR, 3.492; 95% CI, 1.426-8.553; p = 0.006) was an independent risk factor. Kaplan-Meier curves showed that patients in group B had shorter mid-term survival than those in group A (log-rank p < 0.001).

Conclusion: Malnutrition was strongly associated with mid-term mortality in patients with infrarenal AAA treated with EVAR.

Keywords: abdominal aortic aneurysm; controlling nutritional status score; endovascular aneurysm repair; malnutrition; midterm mortality.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by grants from the National Natural Science Foundation of China (nos. 82070496, 82100517), the Affiliated Drum Tower Hospital, Medical School of Nanjing University (no. 2023-LCYJ-PY-23), and the 2020 Drug Regulatory Scientific Research Program Project (no. 202014), Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University (no. 2021-LCYJ-ZD-03), the Natural Science Foundation of Jiangsu Province (SBK2020042213), the 2020 Jiangsu Province Shuangchuang Ph.D. Introducing Talent Project, and the fundings for Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University of Xiaolong Du.