Association Between Naples Prognostic Score and All-Cause and Cardiovascular Mortality in Stroke Patients

Stroke is a primary public health challenge worldwide, with its prognosis profoundly related to inflammation and nutritional status. Naples prognostic score (NPS) is an integrated indicator of combined inflammation and nutrition. The study aimed to elucidate the link between NPS and all-cause and cardiovascular (CVD) deaths in stroke patients.

NHANES (2001 to 2018) data set was used. Multivariate corrected Cox models, Kaplan-Meier, and restricted cubic spline analysis were adopted to explore the link between NPS, all-cause, and CVD mortality in stroke patients. Subgroup analyses based on age, sex, BMI, education, alcohol consumption, smoking, hypertension, and diabetes were performed to further explore associations.

Totally, 1247 stroke patients were enrolled. High NPS levels were notably linked with a heightened risk of all-cause mortality (HR: 1.320, 95% CI: 1.180-1.470, P <0.001) and CVD death (HR: 1.390, 95% CI: 1.120-1.730, P =0.003) in stroke patients after adjusting for relevant factors. Compared with group 0 (NPS=0), group 2 (NPS=3-4) had a high hazard ratio for all-cause mortality (HR: 2.920, 95% CI: 1.820-4.670, P <0.001) and CVD mortality (HR: 2.610, 95% CI: 1.140-5.970, P =0.023). The RCS suggested a linear link between NPS and both all-cause ( P for nonlinear=0.2202) and CVD deaths ( P for nonlinear=0.9841) in stroke patients. These links were mostly consistent in subgroups. There was no pronounced interaction between status and NPS scores for each subgroup (all P <0.05).

High NPS scores are connected with an augmented risk of all-cause mortality and CVD death in stroke patients. NPS is possibly connected with prognosis in stroke patients.