Malnutrition Evaluated by CONUT Score and Its Association With Acute Kidney Injury in Acute Myocardial Infarction Patients: A Retrospective Study

采用 CONUT 评分评估营养不良及其与急性心肌梗死患者急性肾损伤的相关性:一项回顾性研究

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Abstract

Background: The relationship between nutritional status at the start of treatment for acute myocardial infarction (AMI) and the onset of acute kidney injury (AKI) remains unclear. This study aimed to clarify the association between nutritional status, as assessed by the controlling nutritional status (CONUT) score before catheter treatment, and the development of AKI in patients with AMI. Methods: This retrospective study included AMI patients treated with percutaneous coronary intervention (PCI) immediately after admission at our institution between 2014 and 2018. Patients undergoing chronic hemodialysis were excluded. Nutritional status was evaluated using the CONUT score derived from blood tests at admission, with scores below 5 indicating good nutrition and scores of 5 or above indicating malnutrition. The two groups were compared retrospectively. Results: A total of 211 AMI patients were included, with a median age of 68 years (59-79), and 156 (74%) were male. The median door-to-balloon time was 74 min (59-94). There were 180 patients in the good nutrition group and 31 in the malnutrition group. The malnutrition group exhibited significantly higher mortality (1.1% vs. 12.9%, p < 0.001) and a higher incidence of AKI (19% vs. 52%, p < 0.001). Multivariable logistic regression analysis identified lactic acid (odds ratio [OR] = 1.570 and 95% confidence interval [CI] 1.310-1.882), baseline creatinine (OR = 7.403 and 95% CI 1.852-29.59), and malnutrition (OR = 3.715 and 95% CI 1.278-10.80) as independent risk factors for AKI. Conclusions: Malnutrition, assessed by the CONUT score before treatment, may be associated with an increased risk of AKI in AMI patients.

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