Prognostic Value of the CONUT Score in Predicting All-Cause Mortality in Hospitalized Internal Medicine Patients: A...

Aim: This study aimed to evaluate the prognostic significance of the CONUT score and its association with all-cause mortality in hospitalized internal medicine patients. Methods: This retrospective cohort study included hospitalized adult patients followed for long-term all-cause mortality. Demographic data, laboratory parameters, comorbidities, and CONUT scores were recorded at admission. The CONUT score was calculated using serum albumin, total cholesterol, and lymphocyte count. Survival analysis was performed using the Cox proportional hazards regression model. Variables with p < 0.1 in univariate analysis were entered into the multivariate model. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. The primary outcome was all-cause mortality. Results: During the follow-up period, the CONUT score showed a strong and significant association with mortality. In multivariate Cox regression analysis, age, CONUT score, and chronic renal disease were identified as independent predictors of all-cause mortality. Each one-year increase in age was associated with a 5.3% increase in mortality risk (HR = 1.053, 95% CI: 1.048-1.058, p < 0.001). Each one-point increase in CONUT score nearly doubled the risk of death (HR = 1.219, 95% CI: 1.190-1.250, p < 0.001). The presence of chronic renal failure (HR = 2.142, p < 0.001) and solid organ malignancy (HR=1.216 p < 0.001) significantly increased mortality risk. Conclusions: The CONUT score is a powerful and independent predictor of all-cause mortality in hospitalized internal medicine patients. As a simple, inexpensive, and routinely available tool, CONUT can be easily integrated into daily clinical practice for early risk stratification and identification of high-risk patients who may benefit from closer monitoring and nutritional intervention.