Liu Jun, Sun Lian-Lian, Wang Jue, Ji Guang
Wenzhou Medical University.
Cardiol J. 2018;25(3):371-376. doi: 10.5603/CJ.a2017.0075. Epub 2017 Jun 27.
Blood urea nitrogen (BUN) has been shown to be associated with adverse cardiovascular disease outcomes. The aim of the present study was to evaluate the prognostic role of BUN in patients with acute aortic dissection (AAD).
BUN has correlation with in-hospital mortality of patients with AAD.
Patients admitted to the emergency room within the first 24 h of onset of AAD were included in the study. BUN levels were measured on admission and the endpoints were mortality during hospi-talization after receiving surgical or endovascular repair.
A total of 192 patients with AAD were enrolled. During hospitalization, 19 patients died and 173 patients survived. Increased levels of BUN (8.9 [7.0-9.7] vs. 6.0 [5.1-7.2] mmol/L, p < 0.001) were found in non-survivors compared with those survived. Using multivariable logistic analysis, BUN was an independent predictor of in-hospital mortality in patients with AAD (OR 1.415, 95% CI 1.016-1.971, p = 0.040). Furthermore, using receiver operating characteristic analysis, the optimal cutoff value for BUN was 6.95 mmol/L. Under this value, the area under the curve was 0.785 (95% CI 0.662-0.909, p < 0.001) and the sensitivity and specificity to predict in-hospital mortality was 78.9%, and 72.2%, respectively.
Admission BUN levels were an independent predictor for in hospital mortality in pa-tients with AAD.
血尿素氮（BUN）已被证明与不良心血管疾病结局相关。本研究的目的是评估BUN在急性主动脉夹层（AAD）患者中的预后作用。
BUN与AAD患者的院内死亡率相关。
本研究纳入了在AAD发病后24小时内入住急诊室的患者。入院时测量BUN水平，终点为接受手术或血管腔内修复后住院期间的死亡率。
共纳入192例AAD患者。住院期间，19例患者死亡，173例患者存活。与存活患者相比，非存活患者的BUN水平升高（8.9 [7.0 - 9.7] vs. 6.0 [5.1 - 7.2] mmol/L，p < 0.001）。使用多变量逻辑分析，BUN是AAD患者院内死亡率的独立预测因素（OR 1.415，95% CI 1.016 - 1.971，p = 0.040）。此外，使用受试者工作特征分析，BUN的最佳截断值为6.95 mmol/L。在此值下，曲线下面积为0.785（95% CI 0.662 - 0.909，p < 0.001），预测院内死亡率的敏感性和特异性分别为78.9%和72.2%。
入院时的BUN水平是AAD患者院内死亡率的独立预测因素。
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