Predictive value of the modified controlling nutritional status score for critical events in patients with amyotrophic lateral sclerosis

Background & aims Amyotrophic lateral sclerosis (ALS) is associated with various clinical challenges and critical outcomes. Therefore, we established a regional registry and conducted the Chugoku ALS Retrospective and Prospective (CARP) study. The modified controlling nutritional status (m-CONUT) score holds the potential to comprehensively assess the condition of patients with ALS from aspects such as nutrition, metabolism, and inflammation. The present study used data from the CARP study to examine the relationship between the m-CONUT score and outcomes.Methods Patients diagnosed with possible, probable, and definite ALS according to the Awaji criteria were enrolled between 2014 and 2023. A statistical analysis of data from patients enrolled within 2 years of ALS onset and followed for at least 6 months thereafter was performed. Patients were evaluated every 3 months, and missing values were supplemented by the last observation carried forward method.Results This study included 36 patients. Eleven experienced critical events (ventilator placement or death), the majority of which were deaths. The m-CONUT score exhibited a worsening trend before the critical event occurred, as did the revised ALS functional rating scale score, body mass index, and forced vital capacity percentage. Critical events increased significantly with each 1-point increase in the m-CONUT score.Conclusions The m-CONUT score may have potential for predicting outcomes in patients with ALS.