Evaluation of The Predictive Power of Blood Urea Nitrogen/Albumin Ratio for in-Hospital Mortality in Critically Ill Patients

The association between blood urea nitrogen (BUN) and prognosis has been the focus of recent research. Therefore, the objective of this study was to investigate the association between BUN and hospital mortality in critically ill patients with cardiogenic shock (CS). This was a retrospective cohort study, in which data were obtained from the Medical Information Mart for Intensive Care III V1.4 database. Data from 697 patients with CS were analyzed. Logistic regression and subgroup analyses were used to assess the association between BUN and hospital mortality in patients with CS. The average age of the 697 participants was 71.14 years, and approximately 42.18% were men. In the multivariate logistic regression model, after adjusting for age, sex, diabetes, cardiac arrhythmias, urine output, simplified acute physiology score II, sequential organ failure assessment, creatinine, anion gap, and heart rate, high BUN demonstrated strong associations with increased in-hospital mortality (per standard deviation increase: odds ratio [OR] 1.47, 95% confidence interval [CI] 1.13–1.92). A similar result was observed in BUN tertile groups (BUN 23–37 mg/dL versus 6–22 mg/dL: OR [95% CI], 1.42 [0.86–2.34]; BUN 38–165 mg/dL versus 6–22 mg/dL: OR [95% CI], 1.99 [1.10–3.62]; P trend 0.0272). Subgroup analysis did not reveal any significant interactions among various subgroups, and higher BUN was associated with adverse clinical outcomes in patients with CS.

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Blood urea nitrogen to albumin ratio is a predictor of in-hospital mortality in older emergency department patients

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2020.10.008 ◽

2020 ◽

Author(s):

Zerrin Defne Dundar ◽

Kadir Kucukceran ◽

Mustafa Kursat Ayranci

Keyword(s):

Emergency Department ◽

Hospital Mortality ◽

Blood Urea Nitrogen ◽

Urea Nitrogen ◽

Albumin Ratio ◽

Emergency Department Patients

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Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of “normal” creatinine*

Critical Care Medicine ◽

10.1097/ccm.0b013e3181ffe22a ◽

2011 ◽

Vol 39 (2) ◽

pp. 305-313 ◽

Cited By ~ 69

Author(s):

Kevin Beier ◽

Sabitha Eppanapally ◽

Heidi S. Bazick ◽

Domingo Chang ◽

Karthik Mahadevappa ◽

...

Keyword(s):

Critically Ill ◽

Blood Urea Nitrogen ◽

Critically Ill Patients ◽

Urea Nitrogen ◽

Long Term Mortality

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Elevation of Blood Urea Nitrogen is Predictive of Long-term Mortality in Critically Ill Patients Independent of “Normal” Creatinine

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2011.04.013 ◽

2011 ◽

Vol 40 (6) ◽

pp. 724 ◽

Cited By ~ 3

Author(s):

Nicole Seleno

Keyword(s):

Critically Ill ◽

Blood Urea Nitrogen ◽

Critically Ill Patients ◽

Urea Nitrogen ◽

Long Term Mortality

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Blood Urea Nitrogen to Serum Albumin Ratio Independently Predicts Mortality in Critically Ill Patients With Acute Pulmonary Embolism

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211010241 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110102

Author(s):

Jihong Fang ◽

Bin Xu

Keyword(s):

Pulmonary Embolism ◽

Serum Albumin ◽

Critically Ill ◽

Blood Urea Nitrogen ◽

Critically Ill Patients ◽

Acute Pulmonary Embolism ◽

Acute Physiology Score ◽

Icu Mortality ◽

Urea Nitrogen ◽

Icu Admission

Acute pulmonary embolism (APE) is one of the prominent causes of death in patients with cardiovascular disease. Currently, reliable biomarkers to predict the prognosis of patients with APE are limited. The present study aimed to investigate the association of blood urea nitrogen to serum albumin (B/A) ratio and intensive care unit (ICU) mortality in critically ill patients with APE. A retrospective cohort study was performed using data extracted from a freely accessible critical care database (MIMIC-III). Adult (≥18 years) patients of first ICU admission with a primary diagnosis of APE in the database were enrolled in the study. The primary endpoint was the ICU mortality rate while the 28-day mortality after ICU admission was the secondary endpoint. The data of survivors and non-survivors were compared. A total of 1048 patients with APE were enrolled in this study, of which 131 patients died in ICU and 169 patients died within 28 days after ICU admission. The B/A ratio in the non-survivors group was significantly higher compared to the survivors group ( P < 0.001). The multivariate analysis revealed that the B/A ratio was an independent predictor of ICU mortality (odds ratio [OR] 1.10, 95% CI 1.07-1.14, P < 0.001) and all-cause mortality within 28 days after ICU admission (hazard ratio [HR] 1.07, 95% CI 1.05-1.09, P < 0.001) in APE patients. The B/A ratio showed a greater area under the curve (AUC) of ICU mortality prediction (0.80; P < 0.001) than simplified acute physiology score II (SAPSII) (0.79), systemic inflammatory response syndrome score (SIRS) (0.62), acute physiology score III (APSIII) (0.76) and sequential organ failure assessment (SOFA) score (0.71). The B/A ratio could be a simple and useful prognostic tool to predict mortality in critically ill patients with APE.

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