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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 |
doi: 10.3389/fnut.2025.1529754
This article is part of the Research Topic The Relationship between Nutrition and Frailty/Multimorbidity: Prevention and Clinical Nutritional Management View all 4 articles
The prognostic significance of malnutrition in elderly patients with acute ischemic stroke
Provisionally accepted- 1 Graduate School, Hebei North University, Zhangjiakou, China
- 2 Chinese People's Liberation Army Air Force Medical Center, Beijing, China
Background:The most appropriate nutritional assessment tool for predicting the short-term prognosis of elderly patients with AIS was identified from five nutritional assessment tools, including the PNI, HALP Score, the NPS, the GNRI, and the CONUT Score.Methods: A total of 585 elderly patients with AIS were retrospectively analyzed and divided into two groups according to the modified Rankin Scale (mRS) score. The first group, comprising 111 cases, was classified as having a poor prognosis (mRS score >2), while the second group, consisting of 391 cases, was classified as having a good prognosis (mRS score ≤2). A total of five nutritional assessment tools, including PNI, HALP Score, NPS, GNRI, and CONUT, were employed to evaluate the nutritional status of elderly patients with AIS and for the analysis of the relationship between nutritional status and prognosis. The incremental value of five nutritional assessment tools in predicting patient prognosis was compared by means of the IDI and the NRI. The efficacy of each nutritional assessment tool in forecasting the incidence of unfavorable outcomes in elderly patients with AIS within a one-year timeframe was evaluated by utilizing the area under the receiver operating characteristic curve (AUC), calibration curves, and decision analysis curves. Comparative analyses were also conducted.Result: Among the five nutritional assessment tools, the PNI (AUC: 0.619, 95% CI: 0.560-0.679, P < 0.001) and HALP score (AUC: 0.612, 95% CI: 0.552-0.672, P < 0.001) demonstrated a significantly greater area under the ROC curve (AUC) compared to the NPS (AUC: 0.597, 95% CI: 0.536-0.658, P = 0.002), CONUT score (AUC: 0.582, 95% CI: 0.520-0.644, P = 0.009), and GNRI (AUC: 0.590, 95% CI: 0.529-0.651, P < 0.001). When compared to BMI, PNI exhibited a more pronounced improvement in the integrated discrimination index (IDI: 0.0203, P = 0.0061). Similarly, the net reclassification index (NRI) also showed a significant improvement (NRI: 0.2422, P = 0.024), indicating the superior performance of PNI in risk stratification.Among the five types of nutritional assessment tools employed in this study, the PNI was the most effective at predicting a poor prognosis at one year in elderly patients with AIS.
Keywords: Acute ischemic stroke, Prognostic Nutrition Index, Naples prognostic score, Controlling nutritional status, Geriatric Nutritional Risk Index, Hemoglobin, Albumin, Lymphocyte and Platelet Score
Received: 17 Nov 2024; Accepted: 20 Jan 2025.
Copyright: © 2025 Jiang, Zhu, Yin, Liu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tian-Tian Jiang, Graduate School, Hebei North University, Zhangjiakou, China
Xingyu Zhu, Graduate School, Hebei North University, Zhangjiakou, China
Yan-Wei Yin, Chinese People's Liberation Army Air Force Medical Center, Beijing, China
Hong-Jin Liu, Chinese People's Liberation Army Air Force Medical Center, Beijing, China
Guang-Yun Zhang, Chinese People's Liberation Army Air Force Medical Center, Beijing, China
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