Özdemir Serdar, Altunok İbrahim
Department of Emergency Medicine, Ümraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Avicenna J Med. 2023 Feb 23;13(1):43-48. doi: 10.1055/s-0043-1761471. eCollection 2023 Jan.
Hematological parameters and their ratios are the most studied biomarkers for prediction of mortality or severe illness in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to compare the power of the blood urea nitrogen (BUN)/albumin ratio, lactate/albumin ratio, and C-reactive protein (CRP)/albumin ratio, measured at the time of admission, in predicting 30-day mortality in SARS-CoV-2-infected patients presenting to the emergency department (ED). This retrospectively designed, single-center, observational study was performed in the ED of a tertiary education health care center. We documented the data of patients admitted with a confirmed SARS-CoV-2 infection between September 1, 2020, and January 1, 2021. Of the 470 patients included in the study, 232 (49.4%) were female. The all-cause 30-day mortality rate was 23.8%. The area under the curve values for the BUN/albumin ratio, lactate/albumin ratio, and CRP/albumin ratio in the prediction of 30-day mortality were 0.725, 0.641, and 0.749, respectively. Sensitivity and negative predictive value for CRP/albumin ratio (≥0.049) and specificity for BUN/albumin ratio (≥1.17) were 92.86, 94.9, and 71.23, respectively. The odds ratio values of the BUN/albumin ratio (≥1.17), CRP/albumin ratio (≥0.049), and lactate/albumin ratio (≥0.046) for 30-day mortality were determined as 4.886, 9.268, and 2.518, respectively. The BUN/albumin ratio and CRP/albumin ratio can be used to predict 30-day mortality in SARS-CoV-2-infected patients admitted to ED. Furthermore, CRP/albumin ratio had the highest sensitivity and negative predictive value, while BUN/albumin ratio had the highest specificity.
血液学参数及其比值是预测严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者死亡率或重症最常研究的生物标志物。本研究旨在比较入院时测得的血尿素氮（BUN）/白蛋白比值、乳酸/白蛋白比值和C反应蛋白（CRP）/白蛋白比值对急诊科（ED）就诊的SARS-CoV-2感染患者30天死亡率的预测能力。 这项回顾性设计的单中心观察性研究在一家高等教育医疗中心的急诊科进行。我们记录了2020年9月1日至2021年1月1日期间确诊为SARS-CoV-2感染的入院患者的数据。 在纳入研究的470例患者中，232例（49.4%）为女性。全因30天死亡率为23.8%。BUN/白蛋白比值、乳酸/白蛋白比值和CRP/白蛋白比值预测30天死亡率的曲线下面积值分别为0.725、0.641和0.749。CRP/白蛋白比值（≥0.049）的敏感性和阴性预测值以及BUN/白蛋白比值（≥1.17）的特异性分别为92.86、94.9和71.23。BUN/白蛋白比值（≥1.17）、CRP/白蛋白比值（≥0.049）和乳酸/白蛋白比值（≥0.046）对30天死亡率的比值比分别确定为4.886、9.268和2.518。 BUN/白蛋白比值和CRP/白蛋白比值可用于预测入住ED的SARS-CoV-2感染患者的30天死亡率。此外，CRP/白蛋白比值具有最高的敏感性和阴性预测值，而BUN/白蛋白比值具有最高的特异性。
