The predictive value of controlling the nutritional status score for the early prognosis of lung transplantation in patients with idiopathic pulmonary fibrosis
10.16151/j.1007-810x.2024.03.002
- VernacularTitle:COUNT评分对于特发性肺纤维化病人肺移植早期预后的预测价值
- Author:
Min LIU
1
;
Xiao-Wan LI
;
Yi-Feng WANG
;
Yue SUN
;
Jing TIAN
;
Yan DONG
;
Song WANG
;
Hong-Yang XU
Author Information
1. 南京医科大学附属无锡人民医院重症医学科,江苏无锡 214023
- Keywords:
Controlling nutritional status score;
COUNT score;
Lung transplantation;
Risk factor
- From:
Parenteral & Enteral Nutrition
2024;31(3):135-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of the controlling nutritional status (COUNT) score for the early prognosis of lung transplantation in patients with idiopathic pulmonary fibrosis (IPF). Methods:Retrospective collection of 154 patients with IPF who underwent lung transplantation at Wuxi People's Hospital,preoperative data including demographics,preoperative comorbidities,and last laboratory findings,intraoperative as well as postoperative complications were collected. The ability of COUNT score and other nutritional assessment tools to predict 30-day survival was assessed using ROC curves,survival curves for the low and high COUNT score groups were plotted using the Kaplan-Meier method,and log-rank compared the difference in survival between the two groups. COX regression was also used to analyze independent risk factors for poor 30-day postoperative prognosis in IPF patients. Results:According to the division of COUNT score,there were 101 cases (65.6％) of preoperative combined malnutrition in IPF patients. COUNT score was more predictive of poor early 30-day prognosis in IPF lung transplant patients than BMI,Alb,and PNI indices. Using a cutoff value of 2.5 determined by ROC to divide the high group and low COUNT group,the 30-d and 90-d survival rates of the high COUNT group were lower than those of the low COUNT group (P<0.05). And the high COUNT group had a higher APACHE Ⅱ score 24h before ICU admission,a higher incidence of postoperative AKI,a longer duration of postoperative mechanical ventilation,and a longer duration of ECMO diversion (P<0.05). The multivariate COX regression analysis suggested that low COUNT score and obesity were independent risk factors for poor prognosis in IPF patients 30 days after lung transplantation. Conclusion:COUNT score is a predictor of poor prognosis in early lung transplantation,and nutritional assessment is essential before lung transplantation in patients with IPF.
