Department of Emergency Medicine, College of Medicine, Seoul, Chung-Ang University, Seoul, Republic of Korea; Department of Emergency Medicine, College of Medicine, Graduate School of Chung-Ang University, Seoul, Republic of Korea.
Ewha Womans University Mokdong Hospital, Department of Emergency Medicine, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, Republic of Korea.
Am J Emerg Med. 2021 Sep;47:198-204. doi: 10.1016/j.ajem.2021.03.081. Epub 2021 Apr 9.
Early prediction of patients' prognosis in the emergency department (ED) is important. Patients' conditions such as dehydration help predict prognosis. The ratio of serum blood urea nitrogen to creatinine (BUN/Cr ratio) and inferior vena cava (IVC) diameter is often used to determine dehydration. Also, serum albumin levels reflect nutritional conditions such as dehydration. In this study, we evaluated the performance of BUN/Cr ratio, IVC diameter ratio, and BUN/Albumin ratio as predictive markers for in-hospital mortality and ICU admission among various diseases in ED.
This retrospective cohort study utilized data from patients who had abdominal and pelvic computed tomography (APCT) performed at our institution from 2015 to 2018. The measurement of IVC diameter from computed tomography, the BUN/Cr ratio, and the BUN/Albumin ratio were calculated. Differences in the performance among the BUN/Cr ratio, the IVC diameter ratio, and the BUN/Albumin ratio for predicting outcomes were evaluated by the area under the receiver operating characteristic (AUROC) curve.
A total of 914 patients were enrolled and 78 patients (8.5%) were admitted to the ICU, and 71 patients (7.8%) died during the clinical process. Multivariate logistic regression showed that only the BUN/Albumin ratio was a significant predictor of inhospital mortality and ICU admission.
Among dehydration markers the BUN/Albumin ratio is a simple and useful tool for predicting the outcomes of patients visiting the ED.
在急诊科（ED）早期预测患者的预后很重要。患者的脱水等情况有助于预测预后。血清血尿素氮与肌酐（BUN/Cr 比值）和下腔静脉（IVC）直径比通常用于确定脱水情况。此外，血清白蛋白水平反映了脱水等营养状况。在这项研究中，我们评估了 BUN/Cr 比值、IVC 直径比和 BUN/Albumin 比值作为 ED 中各种疾病住院死亡率和 ICU 入院的预测指标的性能。
这是一项回顾性队列研究，使用了 2015 年至 2018 年在我院进行腹部和骨盆计算机断层扫描（APCT）的患者数据。从计算机断层扫描中测量 IVC 直径，计算 BUN/Cr 比值和 BUN/Albumin 比值。通过接受者操作特征（ROC）曲线下面积（AUROC）评估 BUN/Cr 比值、IVC 直径比和 BUN/Albumin 比值在预测结果方面的性能差异。
共纳入 914 例患者，78 例（8.5%）患者入住 ICU，71 例（7.8%）患者在临床过程中死亡。多变量逻辑回归显示，只有 BUN/Albumin 比值是住院死亡率和 ICU 入院的显著预测因子。
在脱水标志物中，BUN/Albumin 比值是一种简单而有用的工具，可预测 ED 就诊患者的结局。
