Controlling the Nutritional Status Score: A New Tool for Predicting Postoperative Mortality in Patients with Infrarenal Abdominal Aortic Aneurysm Treated with Endovascular Aneurysm Repair

Abstract

Abstract Background Abdominal aortic aneurysm is a fatal condition that commonly occurs during vascular surgery. In many diseases, nutritional status is closely associated with prognosis. Scores from the Controlling Nutritional Status (CONUT) screening tool have been shown to predict outcomes of certain malignancies and chronic diseases. However, the impact of nutritional status on abdominal aortic aneurysm (AAA) treated with endovascular aneurysm repair (EVAR) has not yet been reported. In this study, we explored the relationship between CONUT scores and postoperative prognoses of AAA patients treated with EVAR. Methods This was a retrospective review of 177 AAA patients treated with EVAR from June 2018 to November 2019 in a single center. Patient characteristics, nutritional status (CONUT scores), and postoperative status were collected. These patients were divided into groups A and B based on the CONUT scores. We compared the baseline characteristics of the two groups. Cox proportional risk and logistic regression analyses were used to determine the independent predictors of mid − term mortality and complications, respectively. Results Compared with group A, patients in group B had higher midterm mortality (P < 0.001). Univariate analysis showed that CONUT scores; respiratory diseases; stent types; preoperative hemoglobin (Hb), preoperative C − reactive protein, preoperative prothrombin time, and preoperative fibrinogen levels were risk factors for death. Multivariate analysis confirmed that CONUT score [hazard ratio, 1.276; 95% confidence interval (CI), 1.029–1.584; P = 0.027] was an independent risk factor for mortality. Logistic regression analysis showed that prior arterial disease, smoking, and D − dimer levels were risk factors, although multivariate analysis showed smoking (odds ratio, 3.492; 95% CI, 1.426–8.553; P = 0.006) was an independent risk factor. Kaplan − Meier curves showed that patients in group B had shorter mid − term survival than those in group A (log − rank P < 0.001). Conclusion Malnutrition was strongly associated with mid − term mortality in patients with infrarenal AAA treated with EVAR.