Frontiers in Nutrition · Mar 30, 2026

Association between controlling nutritional status (CONUT) and all-cause mortality in elderly hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease: a retrospective cohort study

By Li S, Wang M, Yan J et al.

OBJECTIVE: Nutritional status is a crucial modifiable factor that affects the prognosis of patients with chronic obstructive pulmonary disease (COPD). The CONUT score is a useful tool for comprehensively assessing nutritional status. This study aimed to investigate the relationship between the CONUT score at admission and the 3-year all-cause mortality rate among elderly patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: This retrospective cohort study consecutively enrolled elderly patients hospitalized for AECOPD in the respiratory department of a tertiary hospital between 2013 and 2019. The CONUT score (based on serum albumin, total lymphocyte count, and total cholesterol) was calculated from initial admission laboratory results, categorizing patients into high-score (CONUT ≥ 5) and low-score (CONUT < 5) groups. The primary outcome was all-cause mortality over 3 years. Hazard ratios (HR) and their 95% confidence intervals (CI) were calculated using Cox proportional hazards regression models. Survival analysis was conducted using Kaplan-Meier curves, and dose-response relationships were explored using restricted cubic splines (RCS). Subgroup analyses were performed to assess the consistency of the association between a high CONUT score (≥5) and all-cause mortality. RESULTS: This study included 931 patients with a median follow-up of 30 months. Patients with a high CONUT score (≥5) had a significantly higher risk of 3-year all-cause mortality compared to those with lower scores (adjusted HR = 2.62, 95% CI: 1.69-4.08, P < 0.001). RCS analysis revealed a non-linear association between CONUT score and mortality (P for non-linearity = 0.003). Subgroup analyses confirmed consistent associations across age, sex, smoking status, admission type, and prior AECOPD history. CONCLUSIONS: A higher CONUT score at admission is an independent risk factor for increased 3-year all-cause mortality in elderly hospitalized patients with AECOPD. This finding suggests that the CONUT score may serve as a simple and effective prognostic assessment tool for such high-risk patients, assisting in identifying individuals requiring enhanced nutritional support and management.

doi.org/10.3389/fnut.2026.1765476 Open access PubMed 41983071 Biomarkers