Elevated Blood Urea Nitrogen to Serum Albumin Ratio Is an Adverse Prognostic Predictor for Patients Undergoing Cardiac Surgery

作者全名："Ye, Liu; Shi, Haoming; Wang, Xiaowen; Duan, Qin; Ge, Ping; Shao, Yue"

作者地址："[Ye, Liu; Duan, Qin; Ge, Ping] Chongqing Med Univ, Affiliated Hosp 1, First Branch, Chongqing, Peoples R China; [Shi, Haoming; Wang, Xiaowen; Shao, Yue] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing, Peoples R China"

通信作者："Shao, Y (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiothorac Surg, Chongqing, Peoples R China."

来源：FRONTIERS IN CARDIOVASCULAR MEDICINE

ESI学科分类：　

WOS号：WOS:000797678700001

JCR分区：Q2

影响因子：3.6

年份：2022

卷号：9

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：urea nitrogen; serum albumin; prognosis; intensive care unit; cardiac surgery

摘要："BackgroundElevated blood urea nitrogen (BUN) and reduced albumin have been prominently correlated with unfavorable outcomes in patients with cardiovascular diseases. However, whether combination BUN and albumin levels could predict the adverse outcomes of cardiac surgery patients remains to be confirmed. Here, we investigated the prognostic effect of the preoperative BUN to serum albumin ratio (BAR) in cardiac surgery patients. MethodsData were obtained from the Medical Information Mart for Intensive Care (MIMIC) III and eICU databases and classified into a training cohort and validation cohort. The BAR (mg/g) was calculated by initial BUN (mg/dl)/serum albumin (g/dl). The primary outcome was in-hospital mortality. Secondary outcomes were 1-year mortality, prolonged length at intensive care unit, and duration of hospital stay. The associations of BAR with outcomes were explored by multivariate regression analysis and subgroup analyses. Then, C statistics were performed to assess the added prognostic impact of BAR beyond a baseline risk model. ResultsPatients with in-hospital death had significantly higher levels of BAR. Multivariate regression analysis identified BAR, as a categorical or continuous variable, as an independent factor for adverse outcomes of cardiac surgery (all p < 0.05). Subgroup analyses demonstrated a significant relationship between elevated BAR and in-hospital mortality in different subclasses. The addition of BAR to a baseline model provided additional prognostic information benefits for assessing primary outcome. Results were concordant in the external validation cohort. ConclusionsIncreased preoperative BAR is a potent predictor of unfavorable outcomes in patients undergoing cardiac surgery."

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