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).