Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2025.019

Association of controlling nutritional status score and long-term mortality in acute pulmonary embolism

Kamuran Kalkan1, Cagatay Tunca2, Veysel Ozan Tanik2
1 Department of Cardiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Bilkent City Hospital, Ankara, Turkey
2 Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey

Background and Aims: Pulmonary embolism (PE) is a life-threatening condition with significant short- and long-term mortality risk. Although existing risk stratification models focus on short-term outcomes, the role of nutritional status in predicting long-term mortality remains underexplored. This retrospective study investigated the prognostic value of the Controlling Nutritional Status (CONUT) score, a composite index derived from serum albumin, total cholesterol, and lymphocyte counts.

Methods: A total of 274 patients with confirmed PE were treated at a tertiary care center between January 2021 and March 2023. The primary endpoint was long-term all-cause mortality, as assessed using hospital records and follow-up interviews.

Results: Multivariate analysis identified the CONUT score as an independent predictor of mortality (odds ratio [OR], 1.298; 95% confidence interval [CI], 1.066-1.580; P=0.009). A cut-off score of 2.5 demonstrated high prognostic accuracy (AUC, 0.844; sensitivity, 89%; specificity, 72%). Patients with higher CONUT scores exhibited increased inflammatory marker levels, lower serum albumin levels, and worse outcomes.

Conclusion: These findings highlight CONUT score as a simple and cost-effective tool for assessing nutritional and inflammatory status, enabling improved long-term risk stratification in patients with PE. Future studies should validate these results in diverse populations and evaluate the impact of targeted nutritional and anti-inflammatory interventions on patient outcomes.

Keywords: pulmonary embolism, controlling nutritional status score, CONUT score, long-term mortality

Received: January 20, 2025; Revised: June 10, 2025; Accepted: June 20, 2025; Prepublished online: July 7, 2025 

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