Controlling nutritional status score as a novel prognostic tool for hospital mortality risk stratification in sepsis: a large-scale retrospective cohort analysis.
5 affiliations
- 1Department of Infectious Diseases, Ji'an Central People's Hospital, 106 Jinggangshan Avenue, Jizhou District, Ji'an, Jiangxi Province, 343099, China.
- 2Department of Infectious Diseases, Ji'an Central People's Hospital, 106 Jinggangshan Avenue, Jizhou District, Ji'an, Jiangxi Province, 343099, China. [email protected].
- 3Department of Physical Examination, Ji'an Central People's Hospital, Ji'an, Jiangxi Province, China.
- 4Department of Endocrinology, Ji'an Central People's Hospital, Ji'an, Jiangxi Province, P.R. China.
- 5Department of Emergency, Ji'an Central People's Hospital, Ji'an, Jiangxi Province, P.R. China.
Abstract
Introduction
Malnutrition is associated with poor outcomes in critically ill patients. However, the prognostic value of the Controlling Nutritional Status (CONUT) score in sepsis remains unclear. This study aimed to investigate the association between CONUT score and hospital death in sepsis patients.Methods
In this retrospective cohort study, 2,143 sepsis patients from the eICU Collaborative Research Database were categorized into Mild (2-4 points), Moderate (5-8 points), and Severe (9-12 points) malnutrition groups based on the CONUT score. Multivariable logistic regression analysis was used to evaluate the relationship between CONUT score groups and hospital death. Subgroup analyses were performed to assess the stability of the association across different populations. Restricted cubic spline (RCS) analysis was conducted to examine the potential non-linear relationship between CONUT score and hospital death.Results
Hospital death rates increased progressively across malnutrition groups: 8.13% in Mild, 16.14% in Moderate, and 23.27% in Severe groups (P < 0.001). After fully adjusting for confounding factors, compared with the Mild group, the risk of hospital mortality was significantly higher in the Moderate group (adjusted OR: 1.60, 95% CI: 1.07-2.38, P = 0.021) and Severe group (adjusted OR: 2.66, 95% CI: 1.73-4.07, P < 0.001). Subgroup analyses demonstrated consistent associations across different demographic and clinical characteristics (all P for interaction > 0.05). RCS analysis revealed a significant linear dose-response relationship between CONUT score and risk of hospital mortality (P for overall < 0.001, P for nonlinearity = 0.685). Each one-point increase in CONUT score was associated with a 15% higher adjusted odds of hospital mortality (adjusted OR 1.15, 95% CI 1.09-1.21). The fully adjusted model showed good discrimination (AUC 0.773, 95% CI 0.747-0.799) and excellent calibration (Hosmer-Lemeshow P = 0.390).Conclusion
Higher CONUT scores were independently associated with increased risk of hospital mortality in sepsis patients. The CONUT score might serve as a valuable prognostic indicator for risk stratification in sepsis.
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BibTeX
@article{song2026controlling,
title = {{Controlling nutritional status score as a novel prognostic tool for hospital mortality risk stratification in sepsis: a large-scale retrospective cohort analysis.}},
author = {Wei Song and Hai-Bin Yin and Dan Liu and Di-En Yan and Hui-Lei Zeng and Er-Liang Xie},
journal = {BMC infectious diseases},
year = {2026},
month = jul,
doi = {10.1186/s12879-026-14063-2},
url = {https://europepmc.org/article/MED/42902191},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Controlling nutritional status score as a novel prognostic tool for hospital mortality risk stratification in sepsis: a large-scale retrospective cohort analysis.
AU - Wei Song
AU - Hai-Bin Yin
AU - Dan Liu
AU - Di-En Yan
AU - Hui-Lei Zeng
AU - Er-Liang Xie
PY - 2026
DA - 2026/07/01
JO - BMC infectious diseases
DO - 10.1186/s12879-026-14063-2
UR - https://europepmc.org/article/MED/42902191
AB - Introduction Malnutrition is associated with poor outcomes in critically ill patients. However, the prognostic value of the Controlling Nutritional Status (CONUT) score in sepsis remains unclear. This study aimed to investigate the association between CONUT score and hospital death in sepsis patients.Methods In this retrospective cohort study, 2,143 sepsis patients from the eICU Collaborative Research Database were categorized into Mild (2-4 points), Moderate (5-8 points), and Severe (9-12 points) malnutrition groups based on the CONUT score. Multivariable logistic regression analysis was used to evaluate the relationship between CONUT score groups and hospital death. Subgroup analyses were performed to assess the stability of the association across different populations. Restricted cubic spline (RCS) analysis was conducted to examine the potential non-linear relationship between CONUT score and hospital death.Results Hospital death rates increased progressively across malnutrition groups: 8.13% in Mild, 16.14% in Moderate, and 23.27% in Severe groups (P < 0.001). After fully adjusting for confounding factors, compared with the Mild group, the risk of hospital mortality was significantly higher in the Moderate group (adjusted OR: 1.60, 95% CI: 1.07-2.38, P = 0.021) and Severe group (adjusted OR: 2.66, 95% CI: 1.73-4.07, P < 0.001). Subgroup analyses demonstrated consistent associations across different demographic and clinical characteristics (all P for interaction > 0.05). RCS analysis revealed a significant linear dose-response relationship between CONUT score and risk of hospital mortality (P for overall < 0.001, P for nonlinearity = 0.685). Each one-point increase in CONUT score was associated with a 15% higher adjusted odds of hospital mortality (adjusted OR 1.15, 95% CI 1.09-1.21). The fully adjusted model showed good discrimination (AUC 0.773, 95% CI 0.747-0.799) and excellent calibration (Hosmer-Lemeshow P = 0.390).Conclusion Higher CONUT scores were independently associated with increased risk of hospital mortality in sepsis patients. The CONUT score might serve as a valuable prognostic indicator for risk stratification in sepsis.
SN - 1471-2334
ER -