Blood Urea Nitrogen to Albumin Ratio Was Associated With Mortality in Critically Ill Septic Patients: A Multicenter Retrospective Propensity–Adjusted Analysis

IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Clinical Practice Pub Date : 2024-12-18 DOI:10.1155/ijcp/5202122
Tsai-Jung Wang, Shang-Yi Lee, Li-Ting Wong, Wen-Cheng Chao
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Abstract

Background: Sepsis is a leading cause of mortality worldwide, and increasing studies have found that high ratio of blood urea nitrogen to blood albumin ratio (BAR) was associated with mortality in inflammatory diseases. We used a multicenter database and propensity score–adjusted approach to address the mortality association of BAR in critically ill septic patients.

Methods: Using the eICU Collaborative Research Database, we enrolled adult septic patients who fulfilled the sepsis-3 criteria. We used Cox proportional hazards analysis and propensity score–adjusted analyses, consisting of propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and covariate balancing propensity score (CBPS) to determine hazard ratios (HRs) and 95% confidence intervals (CIs) of in-hospital all-cause mortality.

Results: We analyzed data from 8069 critically ill septic patients in 335 ICUs. The median age was 67 (interquartile range, 56–79) years, with 46.9% being female. The nonsurvivors (31.4%) were older and had higher APACHE IV scores, more shock, and more mechanical ventilation usage. Cox regression identified that higher BAR was independently associated with increased mortality (adjusted HR 1.247, 95% CI 1.142–1.361) after adjusting for covariates. The propensity score–based approach found a consistent and robust association, with adjHRs in the PSM, IPTW, and CBPS populations were 1.191 (95% CI 1.074–1.321), 1.178 (95% CI 1.068–1.299), and 1.215 (95% CI 1.111–1.329), respectively.

Conclusions: This multicenter study demonstrated that high BAR, which is a ready-for-use biomarker in critical care, correlated with increased mortality in critically ill septic patients, and more studies are warranted to explore the underlying mechanism.

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CiteScore
5.30
自引率
0.00%
发文量
274
审稿时长
3-8 weeks
期刊介绍: IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.
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