Relationship between ascites etiology and Controlling Nutritional Status (CONUT) and Prognostic Nutritional Index (PNI)

INTRODUCTION AND GOALS: Identifying the cause of ascites is crucial for predicting the patient's clinical trajectory and devising an effective treatment strategy. This study aims to explore how ascites etiology correlates with Controlling Nutritional Status (CONUT) and Prognostic Nutritional Index (PNI). MATERIALS AND METHODS: We retrospectively analyzed data from patients at Sakarya Training and Research Hospital's Internal Medicine Department over a 2.5- year span, from January 2021 to June 2023. The study included 91 ascites patients. SAAG, CONUT, and PNI scores were calculated for each, and patients were categorized by ascites etiology. Demographic and laboratory data from blood and ascitic fluid were collected for analysis. RESULTS: The study included 91 patients, with 52 females and 39 males, aged on average 67.0±12.1 years. Ascites etiology comprised cirrhosis in 57 (62.6%), malignancy in 20 (22.0%), cardiac causes in 8 (8.8%), and other causes in 6 (6.6%) patients. In the CONUT scores ≥6 group, cirrhotic ascites rate was significantly higher and malignant ascites rate lower. Lower total cholesterol, albumin, and lymphocyte levels were observed in CONUT scores ≥6 group compared to CONUT scores ≤5 group. PNI was significantly lower in CONUT scores ≥6 group. Cirrhotic ascites rate was significantly lower in PNI ≥30 group compared to PNI <30 group. No significant difference was found in rates of malignant ascites and cardiac ascites between PNI ≥30 and PNI <30 groups. Higher albumin and lymphocyte values were noted in PNI ≥30 group compared to PNI <30 group. CONCLUSION: CONUT score ≥6 triples the risk of cirrhotic ascites, while CONUT score ≤5 increases the risk of malignant ascites 3.6 times. A PNI <30 raises the risk of cirrhotic ascites by 4.39 times. Further research with larger, more homogeneous patient cohorts is necessary, given the novelty of this study.