The Controlling Nutritional Status score as a functional prognostic marker in patients with acute stroke: A multicenter retrospective cohort study

Objective: The aim of this study was to assess whether undernutrition on hospital admission, as evaluated by the Controlling Nutritional Status (CONUT) score, has an effect on the improvement in functional and cognitive activities of daily living (ADL) in adult patients with acute stroke. Methods: We retrospectively analyzed data of patients >= 20 y of age with acute stroke between July 2015 and June 2017 in the Noto Liaison Council for Cerebral Stroke of Japan database. We divided the patients into two groups based in CONUT score on admission: high CONUT (5-12), indicating undernutrition, and low CONUT (0-4), indicating no undernutrition. The Functional Independence Measure (FIM) and FIM gain were used to evaluate the patient disability level and change in patient status in response to rehabilitation. Results: Data for 702 patients were extracted from the database. Of the 702 patients, 47.6% were women. A significant difference was found in the motor FIM gain between the two groups. A low CONUT score on admission was independently associated with motor FIM gain (partial regression coefficient beta = -2.874; 95% confidence interval [CI], -5.470 to -0.278). In contrast, a low CONUT score on admission was not independently associated with cognitive FIM gain (beta = -0.229; 95% CI, -0.889 to 0.430). Conclusions: Undernutrition as determined by the CONUT score on admission was an independent predictor of poor motor FIM gain in adult patients with acute stroke. It was not an independent predictor for poor cognitive FIM gain. (C) 2020 Elsevier Inc. All rights reserved.