The Association of Blood Urea Nitrogen to Creatinine Ratio and the Prognosis of Critically Ill Patients with Cerebral Infarction: A Cohort Study

Abstract

Background. To evaluate the association between blood urea nitrogen (BUN) to creatinine (Cr) (BUN/Cr) ratio and the in-hospital mortality of critically ill patients with cerebral infarction in intensive care unit (ICU). Methods. In this cohort study, the data of 3059 participants with cerebral infarction were collected from the Medical Information Mart for Intensive Care (MIMIC)-III and the MIMIC-IV database. After propensity score matching (PSM) on age and gender, 2085 people were involved in and divided into the alive group ( n = 1390 ) and the dead group ( n = 695 ) based on the results of follow-up. Multivariate logistic analyses were applied to identify the confounders and the association between BUN/Cr and mortality of cerebral infarction. Results. The median follow-up time was 10.5 days. Among 2778 participants, 695 were dead at the end of follow-up. Univariate analysis revealed that BUN/Cr [ risk ratio RR = 1.01 , 95% confidence interval (CI): 1.01-1.02] might be associated with the in-hospital mortality of cerebral infarction patients. After adjusting for respiratory failure, malignant cancer, anticoagulation, liver disease, white blood cell (WBC), red cell distribution width (RDW), glucose, bicarbonate, and temperature, BUN/Cr had week correlation with the increased risk of in-hospital mortality of cerebral infarction patients ( RR = 1.01 , 95% CI: 1.01-1.02). Conclusion. This study evaluated the association between BUN/Cr and the in-hospital mortality of cerebral infarction patients in ICU and found that BUN/Cr had weak correlation with the increased risk of in-hospital mortality of patients with cerebral infarction in ICU especially in males and those with respiratory failure, malignant cancer, and without liver disease, as well as those receiving anticoagulation.

Association between the blood urea nitrogen-to-creatinine ratio and 3-month outcomes in patients with acute ischemic stroke: a secondary analysis based on a prospective cohort study

“…In another recent study involving 203 patients, the authors concluded that the BUN/Cr ratio is associated with larger volumes of ischemic tissue measured using diffusion-weighted imaging (DWI), and worse neurological deficits, as assessed by the NIHSS score, in AIS on admission ( 15 ). A broader exploration involving 3,059 AIS cases drawn from the Medical Information Mart for Intensive Care (MIMIC)-III and MIMIC-IV databases, with 2,085 cases subjected to propensity score matching (PSM) based on age and gender, indicated a slight association between the BUN/Cr ratio and an increased risk of in-hospital mortality in patients with AIS (RR = 1.01, 95% CI: 1.01, 1.02) ( 6 ). The disparities between these findings and those of the current study may be attributed to various factors.…”

“…There are many factors affecting the prognosis of stroke, such as age, hypertension, diabetes, heart disease, and stroke etiology, which necessitate robust empirical substantiation. The intricate interplay between dehydration and poststroke prognosis remains a subject of sustained scholarly deliberation, with divergent perspectives on the correlation between dehydration and unfavorable outcomes (4)(5)(6), counterpoised by dissenting opinions (7)(8)(9). In addition, the previous studies were almost all linear studies, with either a small sample size or the insufficient collection of indicators.…”

Exploring the utility of a latent variable as comprehensive inflammatory prognostic index in critically ill patients with cerebral infarction

“…In our study, we diligently improved our research methodology to ensure robust and accurate results. We used the MIMIC-III CareVue subset as an independent validation set, unlike previous studies that combined unfiltered data from MIMIC-III and MIMIC-IV (20)(21)(22)(23)(24), which can lead to data duplication and affect the stability and accuracy of results. In most research on ischemic stroke patients using the MIMIC database, the selection of cases is overly broad.…”

Blood urea nitrogen to creatinine ratio is associated with in-hospital mortality in critically ill patients with venous thromboembolism: a retrospective cohort study

“…The BCR is a straightforward and readily obtainable measure, as it relies solely on venous blood samples in clinical settings. Previous studies have reported an association between the BCR and in-hospital mortality in various diseases (17)(18)(19)(20). BCR, a biomarker of neurohormonal activity, has been associated with poor prognosis in patients with acute heart failure and is an independent predictor of all-cause mortality (31).…”