# CONUT score as a prognostic biomarker in progressive pulmonary fibrosis: a simple tool for clinical risk stratification

## TL;DR

The CONUT score, based on blood markers, helps predict survival and lung function decline in patients with progressive pulmonary fibrosis.

## Contribution

The study introduces the CONUT score as a novel, low-cost tool for risk stratification in progressive pulmonary fibrosis.

## Key findings

- Higher CONUT scores correlate with worse lung function decline and increased mortality in PPF patients.
- Moderate malnutrition (high CONUT score) is linked to significantly worse survival compared to normal nutritional status.
- The CONUT score correlates with serum cholesterol and six-month decline in forced vital capacity.

## Abstract

Progressive pulmonary fibrosis (PPF) is a life-limiting condition characterized by progressive decline in lung function and poor survival. Malnutrition is a frequent but under-recognized factor influencing outcomes in chronic lung diseases. The Controlling Nutritional Status (CONUT) score, derived from serum albumin, cholesterol, and lymphocyte count, may provide a simple prognostic tool in this population.

In this retrospective cohort study, 58 patients with PPF were evaluated. Patients were categorized into three nutritional risk groups according to their CONUT scores: normal, mild, and moderate malnutrition. Clinical parameters, laboratory findings, pulmonary function decline, and survival outcomes were compared. Kaplan–Meier and Cox regression analyses were performed to assess overall survival and identify independent prognostic factors.

Higher CONUT scores were significantly associated with greater reductions in forced vital capacity (FVC) and increased all-cause mortality. Patients with moderate malnutrition showed significantly worse survival compared to those with normal nutritional status (hazard ratio [HR] = 25.92, 95% CI 1.52–40.65, p = 0.024). The CONUT score also correlated with serum cholesterol levels and six-month FVC decline. Steroid use did not significantly affect prognosis.

The CONUT score is a simple, low-cost, and objective biomarker of nutritional risk that may help predict clinical outcomes in patients with PPF. Incorporating nutritional assessment into routine evaluation could improve risk stratification and guide clinical decision-making. Further prospective studies are required to validate its prognostic utility in fibrosing interstitial lung diseases.