Blood urea nitrogen to albumin ratio as a predictive factor for pneumonia: A meta-analysis

Milas, Gerasimos Panagiotis; Issaris, Vasileios; Papavasileiou, Vasileios

doi:10.1016/j.resmer.2022.100886

Cited by 9 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, they all have good calibration performance validated by the Hosmer–Lemeshow test ( p = 0.531; p = 0.7205; p = 0.8121). What’s more, the diagnostic accuracy of some common immune-inflammation indexes, such as neutrophile-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII) and BUN-to-albumin ratio (BUN/ALB) 15 – 17 , were also evaluated in this study, but none of them exhibited better diagnostic accuracy than our proposed WBD model (Fig. 1 d).…”

Section: Resultsmentioning

confidence: 99%

“…BUN is a biomarker of nitrogen excretion caused by hypermetabolism 21 and is often elevated in pneumonia, bacteremia, genitourinary tract infections, and sepsis 17 , 22 – 24 . In this study, BUN was elevated and identified as an independent diagnostic parameter for infection presence in ACLF (AUROC:0.733; OR:1.105), consistent with previous research 25 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A novel laboratory-based nomogram for assessing infection presence risk in acute-on-chronic liver failure patients

Sun,

Lu,

Ren

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Accurate assessment of infection presence risk level, timely diagnosis, and effective control are critical for decreasing mortality of Acute‑on‑chronic liver failure (ACLF). We aimed to develop and validate a novel diagnostic model to accurately assess infection presence risk level in ACLF patients. 185 ACLF patients with/without infection were enrolled, and their demographic, physical findings, immune-inflammatory, hepatic function, metabolism, and coagulation-fibrinolysis indicators were analyzed. Regression analysis was performed to identify the independent diagnostic parameters, which were further used to establish diagnostic models with a nomogram for visual. An area under receiver operating characteristic curve (AUROC), calibration plots, clinical impact curves, decision curve analysis, and net reclassification index were used to evaluate and identify the best model. An external validating cohort was introduced to verify the diagnostic accuracy. We screened out white blood cell (WBC) count, LYM%, blood urea nitrogen (BUN), and D-dimer for assessing infection presence risk levels in ACLF patients. WBD (WBC + BUN + D-dimer) was established and proposed as a novel diagnostic model for infection presence risk levels assessment in ACLF patients with an AUROC of 0.803 (95%CI 0.723–0.883), 0.885 (95%CI 0.786–0.984) in training and external cohorts, respectively. In stratification analysis by ACLF etiology and stages, WBD achieved an AUROC of 0.791 (95%CI 0.691–0.891) and 0.873 (95%CI 0.78–0.966) in HBV-related and early-stage patients, respectively. Whereas a higher AUROC of 0.905 (95%CI 0.807–1.00) in the early-stage of HBV-related ACLF patients indicated its optimum application scope. WBD, a novel laboratory-based nomogram, can serve as a decision-making support tool for clinicians to assess infection presence risk levels in ACLF patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A novel laboratory-based nomogram for assessing infection presence risk in acute-on-chronic liver failure patients

Sun,

Lu,

Ren

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…[24] Elevated BUN level, as an indicator of disease severity, plays an important role in the risk stratification of various diseases such as heart failure, aortic dissection, acute pancreatitis, and peripheral artery disease. [25][26][27][28] In hospitalized ICU patients, elevated BUN levels indicate impaired renal function and are associated with poor prognosis. [29] For COVID-19, major risk factors reported previously include age, masculinity, obesity, smoking, and chronic comorbidities such as hypertension and diabetes.…”

Section: Discussionmentioning

confidence: 99%

Blood urea nitrogen and clinical prognosis in patients with COVID-19: A retrospective study

Yin,

Wang,

Jiang

et al. 2024

Medicine

View full text Add to dashboard Cite

The aim of this study was to estimate the association between blood urea nitrogen (BUN) and clinical prognosis in patients with COVID-19. A multicenter, retrospective study was conducted in adult patients with COVID-19 in 3 hospitals in Zhenjiang from January 2023 to May 2023. Patients were divided into survival and death group based on whether they survived at day 28. The demographic, comorbidities, and laboratory data were independently collected and analyzed, as well as clinical outcomes. Total 141 patients were enrolled and 23 (16.3%) died within 28 days. Patients who died within 28 days had a higher level of BUN compared with survivors. Bivariate logistic regression analysis showed that BUN was a risk factor for 28-day mortality in patients with COVID-19. ROC curve showed that BUN could predict 28-day mortality of COVID-19 patients (AUC = 0.796, 95%CI: 0.654–0.938, P < .001). When the cutoff value of BUN was 7.37 mmol/L, the sensitivity and specificity were 84.62% and 70.31%. Subgroup analysis demonstrated that hyper-BUN (≥7.37 mmol/L) was associated with increased 28-day mortality among COVID-19 patients. Patients with COVID-19 who died within 28 days had a higher level of BUN, and hyper-BUN (≥7.37 mmol/L) was associated with increased 28-day mortality.

show abstract

“…In addition to COVID-19, a previous meta-analysis on 1900 patients has reported a link between a high BUN/albumin ratio and poor prognosis in those with community-acquired pneumonia. [38] Another large-scale retrospective study on 801 septic patients has also identified the BUN/albumin ratio as an independent predictor of mortality from sepsis by demonstrating its strong associations with both the Acute Physiology and Chronic Health Evaluation II and the Sepsis-related Organ Failure Assessment scores, [43] suggesting its versatility as a prognostic predictor in different clinical settings.…”

Section: Discussionmentioning

confidence: 99%

“…An elevated BUN level, which is an indicator of disease severity, has been found to be associated with increased mortality in patients with community-acquired pneumonia. [18,38] In patients with COVID-19, the level of BUN was also higher in those with a fatal outcome or a severe disease compared to those without. [21,22,31] Not only does serum albumin play a vital part in maintaining intravascular colloidal pressure but it is also an acute-phase reactant with antioxidant properties involved in the destruction of free oxygen radicals generated from oxidative stress [39,40] as in COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of blood urea nitrogen-to-albumin ratio for predicting prognostic outcomes of inpatients with COVID-19: A meta-analysis

Hung

Huang

et al. 2023

Medicine

View full text Add to dashboard Cite

Background: The associations between blood urea nitrogen (BUN)/albumin ratio and poor prognosis in patients with diagnosis of coronavirus disease 2019 (COVID-19) remain to be clarified.Methods: A search based on 4 electronic databases (i.e., EMBASE, Google scholar, MEDLINE, and Cochrane Library) was performed on June 23, 2022. The association of BUN/Albumin ratio with poor prognostic outcomes, defined as patients with mortality/severe illnesses, were analyzed.Results: Results from analysis of 7 cohort studies (3600 individuals with COVID-19) published between 2020 and 2022 showed a higher BUN/Albumin ratio in the poor-prognosis group (Mean difference: = 2.838, 95% confidence interval: 2.015-3.66, P < .001, I 2 = 92.5%) than the good-prognosis group. Additional investigation into the connection between BUN/Albumin ratio as a binary variable (i.e., high or low) and the risk of poor outcome also supported an association between a higher BUN/Albumin ratio and a poor prognostic risk (odd ratio = 3.009, 95% confidence interval: 1.565-5.783, P = .001, I 2 = 93.7%, 5 studies). Merged analysis of poor prognosis produced a sensitivity of 0.76, specificity of 0.72, and area under curve of 0.81. Conclusion:This meta-analysis demonstrated a positive correlation between BUN/albumin ratio and poor outcome in patients with COVID-19. Additional large-scale prospective studies are needed to verify our findings.Abbreviations: AUC = area under curve, BUN = blood urea nitrogen, CI = confidence interval, COVID-19 = coronavirus disease 2019, OR = odds ratio, sROC = summary receiver operating characteristic.

show abstract

Blood urea nitrogen to albumin ratio as a predictive factor for pneumonia: A meta-analysis

Cited by 9 publications

References 27 publications

A novel laboratory-based nomogram for assessing infection presence risk in acute-on-chronic liver failure patients

A novel laboratory-based nomogram for assessing infection presence risk in acute-on-chronic liver failure patients

Blood urea nitrogen and clinical prognosis in patients with COVID-19: A retrospective study

Efficacy of blood urea nitrogen-to-albumin ratio for predicting prognostic outcomes of inpatients with COVID-19: A meta-analysis

Contact Info

Product

Resources

About