Researchers studied 205 patients who had surgery for a type of brain bleed called chronic subdural hematoma. They discovered that two simple blood tests measuring nutritional health—called PNI and CONUT—could help doctors predict which patients might have a harder time recovering after surgery. When doctors combined both tests together, they got even better at spotting patients who might struggle. This finding could help doctors identify patients who need extra support during recovery and plan better care from the start.
The Quick Take
- What they studied: Can two blood tests that measure how well-nourished a patient is predict how well someone recovers after surgery for a brain bleed?
- Who participated: 205 patients who had surgery to drain a type of brain bleed called chronic subdural hematoma. Most were likely older adults, since this condition is more common in elderly people.
- Key finding: Both blood tests—especially when used together—could predict which patients might have difficulty recovering. The combined test was about 80% accurate at spotting patients who would struggle.
- What it means for you: If you or a loved one needs this type of brain surgery, doctors might use these simple blood tests to understand recovery risk. This could help them provide better support and monitoring. However, these tests are just one tool and shouldn’t replace a doctor’s full evaluation.
The Research Details
This was a retrospective study, meaning researchers looked back at medical records of patients who had already received treatment. They examined 205 patients who underwent surgery for chronic subdural hematoma—a condition where blood collects between the brain and skull. The doctors measured two nutritional health scores (PNI and CONUT) from blood tests taken when patients were admitted to the hospital. They then tracked how well patients recovered using a standard recovery scale called the modified Rankin scale, measured at hospital discharge. The researchers used statistical methods to see if the blood test scores could predict which patients would have poor recovery outcomes.
This approach is important because it uses information doctors already collect (blood tests) to predict outcomes. If these tests work well, doctors could identify high-risk patients early and provide them with extra nutritional support or closer monitoring. This could potentially improve recovery rates without requiring new or expensive tests.
This study has some strengths: it included a reasonable number of patients (205) and used established statistical methods to test predictions. However, it’s a retrospective study looking at past records rather than following patients forward in time, which is less powerful than a prospective study. The study was conducted at what appears to be a single center, so results might not apply to all hospitals or populations. Only 8.3% of patients had poor outcomes, which is a small number for making predictions. The findings need to be confirmed in other patient groups before being widely adopted.
What the Results Show
The CONUT blood test alone was moderately good at predicting poor recovery, correctly identifying about 72% of cases. The PNI blood test was better, correctly identifying about 80% of cases. When doctors combined both tests together, they achieved about 80% accuracy—slightly better than PNI alone. The study found that patients with higher CONUT scores (worse nutritional status) had worse outcomes, while patients with lower PNI scores (also indicating poorer nutrition) had worse outcomes. These relationships held true even after accounting for other factors like age, high blood pressure, and the amount of fluid around the brain.
The combined score of both tests showed better sensitivity (ability to catch patients who will do poorly) and specificity (ability to correctly identify patients who will do well) compared to using either test alone. This suggests that nutritional status, measured in two different ways, provides useful information about recovery prospects. The study also confirmed that age, high blood pressure, and the amount of fluid around the brain were important factors in recovery, which matches what doctors already knew.
This research adds to growing evidence that nutritional status affects surgical outcomes. Previous studies have shown that malnutrition increases complications after surgery. This study is one of the first to specifically examine whether these nutritional scoring systems can predict outcomes in brain bleed patients. The findings align with the general principle that better-nourished patients tend to recover better from surgery.
The study looked backward at existing records rather than following patients forward, which limits what we can conclude. It was conducted at a single hospital, so results might differ in other settings or populations. Only a small number of patients (17 out of 205) had poor outcomes, making it harder to draw strong conclusions. The study didn’t examine whether improving nutrition before or after surgery could actually improve outcomes—it only showed that nutritional status predicts outcomes. The study didn’t include information about other factors that might affect recovery, like medications or rehabilitation received after discharge.
The Bottom Line
These blood tests may be useful for doctors to identify patients at higher risk of poor recovery after brain bleed surgery (moderate confidence). Doctors might consider using these tests as part of their overall assessment. If tests show poor nutritional status, patients might benefit from nutritional support before or after surgery. However, these tests should not replace a doctor’s clinical judgment or other important assessments.
This research is most relevant for: patients scheduled for brain bleed surgery and their families; neurosurgeons and hospital doctors who treat these patients; hospital nutritionists who support surgical patients. This research is less directly relevant to people without brain bleeds, though the general principle that nutrition affects surgical recovery applies broadly.
Recovery from this type of brain surgery typically takes weeks to months. Nutritional status is measured at the time of hospital discharge (usually days after surgery), so any nutritional interventions would need to happen before or immediately after surgery to potentially help. Patients should expect recovery to be a gradual process, and these tests predict overall recovery patterns, not individual day-to-day progress.
Want to Apply This Research?
- If you’re recovering from brain surgery, track your nutritional intake daily using the app’s food logging feature. Specifically monitor protein intake (aim for 1.2-1.5 grams per kilogram of body weight daily), since protein is critical for healing. Also track calories to ensure you’re eating enough to support recovery.
- Work with your doctor or hospital nutritionist to create a post-surgery nutrition plan. Use the app to set reminders for meals and nutritional supplements if prescribed. If your doctor mentions nutritional risk based on blood tests, prioritize eating protein-rich foods like eggs, fish, chicken, yogurt, and legumes at each meal.
- Track weekly weight to ensure you’re maintaining or gaining weight appropriately during recovery. Monitor energy levels and healing progress (wound healing, strength improvements) and correlate these with your nutritional intake. Share this data with your healthcare team at follow-up appointments to adjust your nutrition plan if needed.
This research describes a medical study about predicting surgical outcomes using blood tests. It is not medical advice. If you have a brain bleed or are scheduled for brain surgery, work with your neurosurgeon and medical team to understand your individual risk factors and treatment options. Nutritional status is just one factor affecting surgical recovery. Do not make changes to your diet or medical care based solely on this information without consulting your doctor. The findings from this single study need to be confirmed by additional research before being widely adopted in clinical practice.