CONUT score predicts length of hospital stay in patients hospitalised with acute decompensated heart failure
C Tunca, B E Yencilek, B Ozlek, V O TanikAbstract
Background
Acute decompensated heart failure (ADHF) is a leading cause of hospitalisation and is associated with substantial morbidity and healthcare resource utilisation. Length of hospital stay (LOS) is a clinically relevant in-hospital outcome reflecting disease severity and response to treatment. Nutritional status plays a key role in heart failure pathophysiology and may influence recovery during hospitalisation. The Controlling Nutritional Status (CONUT) score, derived from serum albumin, total lymphocyte count, and total cholesterol, provides an objective assessment of nutritional and immune status. However, evidence regarding the relationship between admission CONUT score and LOS in ADHF remains limited.
Purpose
To evaluate whether admission CONUT score predicts hospital length of stay and prolonged hospitalisation in patients admitted with ADHF.
Methods
This retrospective study included consecutive patients hospitalised with ADHF between January 2024 and March 2025. The CONUT score was calculated using laboratory parameters obtained within the first 24 hours of admission. Patients were classified into low (CONUT 0–4) and high (CONUT ≥5) nutritional risk groups. The primary outcome was LOS, analysed as both a continuous variable and prolonged hospitalisation, defined as LOS ≥7 days. Multivariable regression analyses were performed to identify independent predictors of prolonged hospitalisation. Discriminative performance was assessed using receiver operating characteristic (ROC) analysis.
Results
A total of 300 patients with ADHF were analysed. Median LOS was 6 days (interquartile range 4–9). Patients with high CONUT scores had significantly longer LOS than those with low scores, and prolonged hospitalisation occurred more frequently in the high CONUT group. After adjustment for age, renal function, systolic blood pressure at admission, left ventricular ejection fraction, and natriuretic peptide levels, high CONUT score remained independently associated with prolonged hospitalisation. ROC analysis demonstrated fair discriminatory performance of admission CONUT score for predicting prolonged LOS (AUC ≈0.72).
Conclusion
Admission CONUT score is a simple and readily available predictor of LOS in patients hospitalised with ADHF. Early identification of patients at risk for prolonged hospitalisation using CONUT may support optimised in-hospital management and resource utilisation.CONUT and prolonged LOSFor image description, please refer to the figure legend and surrounding text.ROC for prolonged LOSFor image description, please refer to the figure legend and surrounding text.