Clinical Value of Controlling Nutritional Status Score in Patients with Aneurysmal Subarachnoid Hemorrhage

The aim of present study was to assess the predictive value of the admission prognostic nutrition index (PNI), controlling nutritional status (CONUT) associated with delayed cerebral ischemia (DCI), and 3-month neurological outcomes after aneurysmal subarachnoid hemorrhage (aSAH).

The clinical data from 252 patients with aSAH were retrospectively analyzed. Receiver operating characteristic analysis was performed to assess the predictive ability of the PNI and CONUT score and identify the cutoff point. Multivariate analysis was conducted to assess the role of the PNI and CONUT score in predicting for DCI and outcomes at 3 months after aSAH treatment.

We enrolled 252 patients with aSAH in our study. Of the 252 patients, 53 experienced DCI and 57 patients had a poor outcome. Patients with unfavorable outcomes had a lower serum albumin, lymphocyte count, total cholesterol, and PNI but a high CONUT score, Hunt-Hess grade, and aneurysm size (P < 0.05). Both the PNI and CONUT score correlated with the Hunt-Hess grade (r = -0.289 and P < 0.001; r = 0.512 and P < 0.001), modified Rankin scale score at 3 months (r = -0386 and P < 0.001; r = 0.533 and P < 0.001), aneurysm size (r = -0.219 and P < 0.001; r = 0.422 and P < 0.001). Only a CONUT score <4 (odds ratio, 0.241; 95% confidence interval, 0.071-0.842; P = 0.022) independently predicted the functional outcome status but not DCI at 3 months after aSAH. However, PNI was an unrelated factor associated with DCI and the clinical outcome.

Our results have indicated that the CONUT score might efficiently predict for the clinical outcomes at 3 month after aSAH.