期刊论文详细信息
BMC Pulmonary Medicine | |
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 | |
Research | |
Xiaocui Ke1  Shan Gong1  Qin Liu1  Juan Cheng1  Xiaoying Huang1  Xin Huang1  Yuqun Li1  Zixiong Zeng1  Liping Wei1  | |
[1]Department of Respiratory Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China | |
关键词: AECOPD; Blood urea nitrogen to serum albumin ratio; Mortality; Prognosis; | |
DOI : 10.1186/s12890-022-02258-7 | |
received in 2022-07-28, accepted in 2022-11-23, 发布年份 2022 | |
来源: Springer | |
【 摘 要 】
BackgroundPrevious studies on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) have found that those who died in hospital had higher blood urea nitrogen levels and a worse nutritional status compared to survivors. However, the association between the blood urea nitrogen to serum albumin ratio (BUN/ALB ratio) and in-hospital and short-term prognosis in patients with AECOPD remains unclear. The aim of this study was to explore the usefulness of BUN/ALB ratio in AECOPD as an objective predictor for in-hospital and 90-day all-cause mortality.MethodsWe recorded the laboratory and clinical data in patients with AECOPD on admission. By drawing the ROC curve for the patients, we obtained the cut-off point for the BUN/ALB ratio for in-hospital death. Multivariate logistic regression was used for analyses of the factors of in-hospital mortality and multivariate Cox regression was used to analyze the factors of 90-day all-cause mortality.ResultsA total of 362 patients were recruited and 319 patients were finally analyzed. Twenty-three patients died during hospitalization and the fatality rate was 7.2%. Furthermore, 14 patients died by the 90-day follow-up. Compared with in-hospital survivors, patients who died in hospital were older (80.78 ± 6.58 vs. 75.09 ± 9.73 years old, P = 0.001), had a higher prevalence of congestive heart failure(69.6% vs. 27.4%, P < 0.001), had a higher BUN/ALB ratio [0.329 (0.250–0.399) vs. 0.145 (0.111–0.210), P < 0.001], had higher neutrophil counts [10.27 (7.21–14.04) vs. 6.58 (4.58–9.04), P < 0.001], higher blood urea nitrogen levels [10.86 (7.10–12.25) vs. 5.35 (4.14–7.40), P < 0.001], a lower albumin level (32.58 ± 3.72 vs. 36.26 ± 4.53, P < 0.001) and a lower lymphocyte count [0.85 (0.58–1.21) vs. 1.22 (0.86–1.72), P = 0.001]. The ROC curve showed that the area under the curve (AUC) of BUN/ALB ratio for in-hospital death was 0.87, (95%CI 0.81–0.93, P < 0.001), the best cut-off point value to discriminate survivors from non-survivors in hospital was 0.249, the sensitivity was 78.3%, the specificity was 86.5%, and Youden’s index was 0.648. Having a BUN/ALB ratio ≥ 0.249 was an independent risk factor for both in-hospital and 90-day all-cause mortality after adjustment for relative risk (RR; RR = 15.08, 95% CI 3.80–59.78, P < 0.001 for a multivariate logistic regression analysis) and hazard ratio (HR; HR = 5.34, 95% CI 1.62–17.57, P = 0.006 for a multivariate Cox regression analysis).ConclusionAn elevated BUN/ALB ratio was a strong and independent predictor of in-hospital and 90-day all-cause mortality in patients with AECOPD.【 授权许可】
CC BY
© The Author(s) 2022
【 预 览 】
Files | Size | Format | View |
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RO202305065253999ZK.pdf | 945KB | download | |
Fig. 1 | 1034KB | Image | download |
MediaObjects/12974_2022_2622_MOESM2_ESM.docx | 8KB | Other | download |
Fig. 1 | 147KB | Image | download |
【 图 表 】
Fig. 1
Fig. 1
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