The Relationship of CONUT Score and Blood Urea Nitrogen/Albumin Ratio With Survival and Neurological Outcome in Patients With Acute Ischemic Stroke Followed in Neurology Intensive Care

Background: Malnutrition is a frequent but underrecognized factor influencing prognosis in acute ischemic stroke (AIS) patients, particularly in intensive care settings. This study is aimed at evaluating the prognostic value of the controlling nutritional status (CONUT) score and the blood urea nitrogen/albumin (BUN/ALB) ratio on neurological outcomes and in‐hospital mortality. Methods: This retrospective cohort study included 208 AIS patients admitted to a neurology intensive care unit between 2020 and 2022. Nutritional status was assessed within 24–48 h using the CONUT score, calculated from serum albumin, total lymphocyte count, and cholesterol. The BUN/ALB ratio was used as an additional marker. Neurological outcomes were evaluated on day 60 using the modified Rankin Scale (mRS). Statistical analyses included univariate and multivariate logistic regression, Cox regression, ROC curve analysis, and Kaplan–Meier survival analysis. Results: Higher CONUT scores and BUN/ALB ratios were significantly associated with poor neurological outcomes and increased in‐hospital mortality. In multivariate analysis, both markers remained independent predictors of poor prognosis (CONUT OR = 3.8, p = 0.013; BUN/ALB OR = 7.4, p = 0.014). ROC analysis showed strong predictive value, especially for the CONUT score (AUC = 0.898 for progression; AUC = 0.860 for mortality). Conclusion: Early assessment of nutritional status using CONUT and BUN/ALB ratio may help identify AIS patients at higher risk of poor outcomes. These cost‐effective and easily obtainable markers can support clinical decision‐making and improve prognostic accuracy in intensive care management.