# Association of CONUT Score with Ultrasound-Measured Muscle Mass and 30-, 45-, and 60-Day Mortality in Geriatric Palliative Care Patients: A Prospective Observational Study

## TL;DR

This study shows that a higher CONUT score is linked to lower muscle mass and higher short-term mortality in elderly palliative care patients.

## Contribution

The study demonstrates the CONUT score's independent predictive value for mortality in geriatric palliative care patients.

## Key findings

- Higher CONUT scores (≥5) were associated with significantly lower muscle mass and higher mortality rates.
- A CONUT score ≥5 and malignancy independently predicted mortality with hazard ratios up to 3.72.
- The CONUT score showed moderate predictive accuracy for 60-day mortality (AUC = 0.736).

## Abstract

Background/Objectives: Early risk assessment of nutritional and muscular status in geriatric palliative care patients may facilitate timely, personalized care. This study aimed to evaluate the association between the CONUT score, ultrasound-assessed muscle mass, and short-term mortality at 30, 45, and 60 days. Methods: This prospective, single-center study was conducted in a tertiary palliative care unit between May and September 2024. Muscle mass was assessed via ultrasound by measuring the thickness and cross-sectional area of the rectus femoris and biceps brachii. Nutritional status was evaluated using the CONUT score (low: ≤4, high: ≥5). Mortality at 30, 45, and 60 days was analyzed using Kaplan–Meier curves, Cox regression, and ROC analysis. Results: In a cohort of 200 geriatric palliative care patients (mean age 78.4 ± 10.2 years; 54.5% female), those with higher CONUT scores (≥5) had significantly lower ultrasound-assessed muscle mass and higher short-term mortality rates (48.6% vs. 11.3%, p < 0.001). A CONUT score ≥ 5 and the presence of malignancy independently predicted mortality, with hazard ratios up to 3.72. The CONUT score demonstrated moderate predictive accuracy for short-term mortality, highest at 60 days (AUC = 0.736). Kaplan–Meier analysis revealed significantly reduced survival among patients with higher CONUT scores. Conclusions: A CONUT score ≥ 5 and malignancy independently predicted short-term mortality, and higher CONUT scores were associated with lower muscle mass. The CONUT score may be a useful tool for early risk assessment in geriatric palliative care, though further research is warranted.