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

Abstract

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.

Prognostic Value of Blood Urea Nitrogen to Serum Albumin Ratio in Intensive Care Unit Patients with Lung Cancer

“…Using the data extracted from MIMIC-III, Fang et al investigated the correlation between BAR and prognosis of 1048 ICU patients with acute pulmonary embolism and concluded that BAR was an independent predictor for ICU mortality as well as 28-day mortality after ICU admission and the predictive performance of BAR was superior to the SOFA score and APSIII score. 30 Moreover, Huang et al conducted a retrospective, observational study of 602 patients and demonstrated that elevated BAR at admission is an independent risk factor for in-hospital mortality in coronavirus disease patients (2019). 31 Our study added the evidence that BAR was a reliable predictor for prognosis of patients with disease of the respiratory system.…”

Blood urea nitrogen to serum albumin ratio as a new prognostic indicator in critical patients with chronic heart failure

“…[7][8][9] Blood urea nitrogen to serum albumin ratio (BAR) is a novel prognostic biomarker discovered in recent years, which combines two important predictors-urea nitrogen and albumin, and this biomarker shows a good predictive effect in the mortality of patients with pneumonia or acute pulmonary embolism. [10][11][12][13][14] Most critically ill patients admitted to the intensive care unit (ICU) have multiple organ damages. Chronic heart failure is a common comorbidity, which makes the mortality rate of these patients higher.…”

Blood urea nitrogen to serum albumin ratio: a good predictor of in-hospital and 90-day all-cause mortality in patients with acute exacerbations of chronic obstructive pulmonary disease

“…For aspiration pneumonia patients, Ryu et al [ 27 ]demonstrated that the BUN/ALB ratio was associated with increased 28-day mortality. In addition, Fang et al [ 28 ]concluded that the BUN/ALB ratio could be a useful prognostic tool to predict mortality in critically ill patients with an acute pulmonary embolism. In our prospective cohort study, we first investigated the association between BUN/ALB ratio and in-hospital and 90-day all-cause mortality.…”