Association of immunonutritional indicators with all-cause mortality in adult stroke patients
Abstract The study aimed to evaluate the relationship between immunonutritional indicators such as the systemic immune-inflammation index (SII), the Naples prognostic score (NPS), nutritional risk index (NRI), serum albumin (ALB), total cholesterol (TC) and all-cause mortality in adult stroke patien...
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Nature Portfolio
2025-04-01
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| Online Access: | https://doi.org/10.1038/s41598-025-99158-7 |
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| author | Kai Deng Shangang Feng Fangyu Cheng Xinyu Zhang Yueyuan Li Jiyu Ju Zengwu Wang Peng Wang Chunping Wang |
| author_facet | Kai Deng Shangang Feng Fangyu Cheng Xinyu Zhang Yueyuan Li Jiyu Ju Zengwu Wang Peng Wang Chunping Wang |
| author_sort | Kai Deng |
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| description | Abstract The study aimed to evaluate the relationship between immunonutritional indicators such as the systemic immune-inflammation index (SII), the Naples prognostic score (NPS), nutritional risk index (NRI), serum albumin (ALB), total cholesterol (TC) and all-cause mortality in adult stroke patients. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) databases for 2005–2018. To determine mortality outcomes, participants were matched with National Death Index records until December 31, 2019. Spearman’s correlation analysis and the random survival forest (RSF) were employed to assess the relationships among NPS, NRI, SII, ALB, and TC, and to determine the most predictive indicator for all-cause mortality in stroke patients. For the selected prognostic indicator, Kaplan–Meier survival analysis and Cox proportional hazards regression models were subsequently utilized to evaluate their associations with all-cause mortality in stroke patients. The study included 1076 stroke patients, with a median (IQR) age of 67 (56, 77) years. During a median follow-up of 67 months, a total of 372 (weighted 31%) stroke participants died from all causes. Among the immunonutritional indicators evaluated, NPS had the strongest predictive power for all-cause mortality in stroke patients. The Kaplan–Meier curve and Log-rank test showed that all-cause mortality was higher in the higher NPS group (3–4) compared to the lower NPS group (0–2) (P < 0.001). After adjusting for multiple potential confounders, the Cox regression model indicated that the higher NPS (3–4) group remained an independent predictor for higher all-cause mortality risk (HR = 1.89, 95% CI 1.44–2.47, P < 0.001). As a comprehensive evaluation index of inflammation and nutrition, NPS is a powerful predictor of all-cause mortality in stroke patients. |
| format | Article |
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| issn | 2045-2322 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-7729d8a64c054a4ea87fa1e5ed2777fb2025-08-20T01:48:53ZengNature PortfolioScientific Reports2045-23222025-04-0115111010.1038/s41598-025-99158-7Association of immunonutritional indicators with all-cause mortality in adult stroke patientsKai Deng0Shangang Feng1Fangyu Cheng2Xinyu Zhang3Yueyuan Li4Jiyu Ju5Zengwu Wang6Peng Wang7Chunping Wang8Department of Occupational and Environmental Health, School of Public Health, Shandong Second Medical UniversityDepartment of Clinical Neurosurgery, The First Affiliated Hospital of Shandong Second Medical UniversityDepartment of Occupational and Environmental Health, School of Public Health, Shandong Second Medical UniversityDepartment of Occupational and Environmental Health, School of Public Health, Shandong Second Medical UniversityDepartment of Occupational and Environmental Health, School of Public Health, Shandong Second Medical UniversityDepartment of Immunology Teaching and Research, School of Public Health, Shandong Second Medical UniversityDepartment of Clinical Neurosurgery, The First Affiliated Hospital of Shandong Second Medical UniversityDepartment of Nutrition, Food and Children’s Health, School of Public Health, Shandong Second Medical UniversityDepartment of Occupational and Environmental Health, School of Public Health, Shandong Second Medical UniversityAbstract The study aimed to evaluate the relationship between immunonutritional indicators such as the systemic immune-inflammation index (SII), the Naples prognostic score (NPS), nutritional risk index (NRI), serum albumin (ALB), total cholesterol (TC) and all-cause mortality in adult stroke patients. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) databases for 2005–2018. To determine mortality outcomes, participants were matched with National Death Index records until December 31, 2019. Spearman’s correlation analysis and the random survival forest (RSF) were employed to assess the relationships among NPS, NRI, SII, ALB, and TC, and to determine the most predictive indicator for all-cause mortality in stroke patients. For the selected prognostic indicator, Kaplan–Meier survival analysis and Cox proportional hazards regression models were subsequently utilized to evaluate their associations with all-cause mortality in stroke patients. The study included 1076 stroke patients, with a median (IQR) age of 67 (56, 77) years. During a median follow-up of 67 months, a total of 372 (weighted 31%) stroke participants died from all causes. Among the immunonutritional indicators evaluated, NPS had the strongest predictive power for all-cause mortality in stroke patients. The Kaplan–Meier curve and Log-rank test showed that all-cause mortality was higher in the higher NPS group (3–4) compared to the lower NPS group (0–2) (P < 0.001). After adjusting for multiple potential confounders, the Cox regression model indicated that the higher NPS (3–4) group remained an independent predictor for higher all-cause mortality risk (HR = 1.89, 95% CI 1.44–2.47, P < 0.001). As a comprehensive evaluation index of inflammation and nutrition, NPS is a powerful predictor of all-cause mortality in stroke patients.https://doi.org/10.1038/s41598-025-99158-7ImmunonutritionNPSStrokeAll-cause mortalityNHANES |
| spellingShingle | Kai Deng Shangang Feng Fangyu Cheng Xinyu Zhang Yueyuan Li Jiyu Ju Zengwu Wang Peng Wang Chunping Wang Association of immunonutritional indicators with all-cause mortality in adult stroke patients Scientific Reports Immunonutrition NPS Stroke All-cause mortality NHANES |
| title | Association of immunonutritional indicators with all-cause mortality in adult stroke patients |
| title_full | Association of immunonutritional indicators with all-cause mortality in adult stroke patients |
| title_fullStr | Association of immunonutritional indicators with all-cause mortality in adult stroke patients |
| title_full_unstemmed | Association of immunonutritional indicators with all-cause mortality in adult stroke patients |
| title_short | Association of immunonutritional indicators with all-cause mortality in adult stroke patients |
| title_sort | association of immunonutritional indicators with all cause mortality in adult stroke patients |
| topic | Immunonutrition NPS Stroke All-cause mortality NHANES |
| url | https://doi.org/10.1038/s41598-025-99158-7 |
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