Prognostic impact of blood urea nitrogen to albumin ratio on patients with sepsis: A retrospective cohort study

Abstract

Objective To investigate the ability of the ratio of blood urea nitrogen (BUN) to serum albumin ratio (BAR) in patients with sepsis in intensive care units (ICUs) to predict the prognosis of short-and long-term death. Methods Data were derived from the Medical Information Market in the Intensive Care IV (MIMIC-IV v2.0) database, with septic patients defined by SEPSIS-3. 30-day mortality for the primary outcome and 360-day mortality for the secondary outcome. Kaplan-Meier (KM) Survival curves were plotted to describe differences in BAR mortality in different subgroups, and area under the curve (AUC) analysis was performed to a comparison of BAR + SOFA and sequential organ failure assessment (SOFA) performance. Multivariate Cox regression models, restricted cubic spline curves (RCS), and subgroup analysis were used to ascertain the correlation between BAR and 30-day mortality and 360-day mortality. Results A total of 7656 eligible patients with a median BAR of 8.0 mg/g were enrolled in the study, with 3837 patients in the ≤ 8.0 group and 3819 in the BAR > 8.0 group, with 30-day mortality rates of (19.1% and 38.2%; P < 0.001)The area under the curve (AUC) was 0.718 (95% CI: 0.705–0.731) for SOFA + BAR and 0.703 (95% CI: 0.690–0.716) for SOFA. In the subgroup analysis, BAR remained an isolated risk element for patient death. For 360-day all-cause mortality, the same pattern was observed after adjustment for the same confounders. Conclusion As a clinically inexpensive and readily available parameter, BAR can be a valuable forecaster of prognosis in patients with sepsis in the intensive care unit.

Urea nitrogen‐to‐albumin ratio predicts ventricular aneurysm formation in ST‐segment elevation myocardial infarction

“…Recently, BAR has been used as a new biomarker to assess the prognosis of various diseases and is an important prognostic factor for death in several diseases, such as pulmonary embolism, 25 sepsis, 9 and lung cancer 26 . Moreover, numerous studies have identified BAR as an independent predictor for mortality risk of AMI 30,39 .…”

“…Blood urea nitrogen (BUN) is the major product of protein metabolism in the human body and is primarily eliminated by the kidney. 9 BUN has been identified as a biomarker for renal function and was linked to the prognosis of various diseases, such as acute aortic dissection, 10 pancreatitis, 11 and acute intracerebral haemorrhage. 12 Recently, there has been growing attention towards the role of BUN in predicting cardiovascular events.…”

“…22 Similarly, Liu et al also identified hypoalbuminaemia as an independent predictor of death in patients with HF with preserved ejection fraction. 23 The BUN-to-ALB ratio (BAR), which is the mathematical ratio of BUN and ALB, has been identified as a novel prognostic factor associated with various diseases, such as ST-elevation myocardial infarction, 24 pulmonary embolism, 25 sepsis, 9 and lung cancer. 26 However, no study has been conducted to investigate the association between BAR and LVA formation.…”

The Prognostic Value of Blood Urea Nitrogen to Albumin Ratio on Patients with Heart Failure

“…The BUN/albumin ratio (BAR) has been identified as a new predictor factor associated with the prognosis of many diseases, including pulmonary embolism, 18) sepsis, 19) STEMI, 20) and lung cancer. 21) Moreover, a retrospective cohort study including 1545 critically ill patients with chronic HF was conducted by Lin, et al They found BAR as an independent risk factor for in-hospital and 90-day mortalities.…”

“…16) A study by Yano, et al revealed that high BUN levels were independently associated with an increased risk of all-cause death and HF readmission. 17) The mathematical ratio of BUN and ALB, namely blood urea nitrogen/albumin ratio (BAR), was identified as a new predictor factor and found to be associated with the prognosis of many diseases, including pulmonary embolism, 18) sepsis, 19) ST-elevation myocardial infarction (STEMI), 20) and lung cancer. This study aimed to evaluate the prognostic value of BAR for patients with HF.…”