The Relationship of Conut Score and Blood Urea Nitrogen/albumin Ratio With Survival and Neurological Outcome in Patients With Acute Ischemic Stroke Followed in Neurology Intensive Care

Abstract

Abstract Background Stroke constitutes the second most prevalent cause of death and morbidity globally, and these patients are at risk of malnutrition due to neurological and cognitive impairments. This study assesses the identification of malnutrition in patients with acute ischemic stroke monitored in intensive care units and investigates whether this condition impacts survival and neurological progression. Methods The study included patients diagnosed with acute ischemic stroke who were followed in the Neurology Intensive Care Unit. Neurological progression was assessed using the modified Rankin scale. The Controlling Nutritional Status score was calculated using total cholesterol, serum albumin levels, and complete blood lymphocyte counts 24 hours after admission. Chi-square or Fisher's test for categorical variables, the Kaplan-Meier method for survival analyses, and univariate analyses for prognostically significant factors were used. Factors with a P-value < 0.05 were assessed with multivariate logistic and Cox regression analyses. Results A total of 208 patients were included in the study. The analyses found significant associations with neurological progression for National Institutes of Health Stroke Scale admission score (OR: 5.6, p < 0.001), stroke due to cardioembolic causes (OR: 7.2, p < 0.001), BUN/Albumin ratio (OR: 8.3, p < 0.001), and Controlling Nutritional Status score (OR: 4.3, p < 0.001). In multivariate analyses, the National Institutes of Health Stroke Scale admission score (OR: 1.2, p:0.003), stroke due to cardioembolic causes (OR: 7.7, p:0.018), BUN/Albumin ratio (OR: 7.4, p:0.014), and Controlling Nutritional Status score (OR: 3.8, p:0.013) were significantly associated with neurological progression. In-hospital mortality rate increased with high Controlling Nutritional Status scores and BUN/Albumin ratio. Conclusions This study delves into the prognostic value of biological parameters, including the Controlling Nutritional Status score and the BUN/Albumin ratio, for determining neurological progression and overall survival. Furthermore, we examine the influence of stroke type and initial National Institutes of Health Stroke Scale values on patient prognosis.