Department of Intensive Care Unit, Liuzhou Workers' Hospital, Liuzhou, China.
Department of Intensive Care Unit, Liuzhou Workers' Hospital, Liuzhou, China
BMJ Open. 2023 Apr 28;13(4):e069345. doi: 10.1136/bmjopen-2022-069345.
Recent studies have shown that blood urea nitrogen to creatinine (BUN/Cr) ratio might be an effective marker for the prognosis of patients with respiratory diseases. Herein, we aimed to assess the association between BUN/Cr ratio and the risk of in-hospital mortality in patients with trauma-related acute respiratory distress syndrome (ARDS).
A retrospective cohort study.
1034 patients were extracted from the Medical Information Mart for Intensive Care-III (MIMIC-III) database.
The primary outcome of the study was in-hospital mortality, defined by the vital status at the time of hospital discharge (ie, survivors and non-survivors).
Of the total patients, 191 (18.5%) died in hospital. The median follow-up duration was 16.0 (8.3-26.6) days. The results showed that high level of BUN/Cr ratio was significantly associated with an increased risk of in-hospital mortality (15.54-21.43: HR=2.00, 95% CI: (1.18 to 3.38); >21.43: HR=1.76, 95% CI: (1.04 to 2.99)) of patients with trauma-related ARDS. In patients with trauma-related ARDS that aged ≥65 years old, male and female, Onychomycosis Severity Index (OSI)>98, Revised Trauma Score (RTS)>11, Simplified Acute Physiology Score II (SAPS-II)>37 and sequential organ failure assessment (SOFA) scores≤7, BUN/Cr ratio was also related to the increased risk of in-hospital mortality (all p<0.05). The predictive performance of BUN/Cr ratio for in-hospital mortality was superior to BUN or Cr, respectively, with the area under the curve of receiver operator characteristic curve at 0.6, and that association was observed in age, gender, OSI, RTS, SAPS-II and SOFA score subgroups.
BUN/Cr ratio may be a potential biomarker for the risk of in-hospital mortality of trauma-related ARDS, which may help the clinicians to identify high-risk individuals and to implement clinical interventions.
最近的研究表明，血尿素氮与肌酐（BUN/Cr）比值可能是预测呼吸系统疾病患者预后的有效标志物。在此，我们旨在评估创伤相关急性呼吸窘迫综合征（ARDS）患者的 BUN/Cr 比值与住院死亡率风险之间的关系。
回顾性队列研究。
从医疗信息集市-III（MIMIC-III）数据库中提取了 1034 名患者。
本研究的主要结局是住院死亡率，定义为出院时的生命状态（即幸存者和非幸存者）。
在总患者中，有 191 人（18.5%）在住院期间死亡。中位随访时间为 16.0（8.3-26.6）天。结果表明，高 BUN/Cr 比值与创伤相关 ARDS 患者住院死亡率增加显著相关（15.54-21.43：HR=2.00，95%CI：（1.18 至 3.38）；>21.43：HR=1.76，95%CI：（1.04 至 2.99））。在年龄≥65 岁、男性和女性、甲真菌病严重程度指数（OSI）>98、修订创伤评分（RTS）>11、简化急性生理学评分 II（SAPS-II）>37 和序贯器官衰竭评估（SOFA）评分≤7 的创伤相关 ARDS 患者中，BUN/Cr 比值也与住院死亡率增加相关（均 P<0.05）。BUN/Cr 比值对住院死亡率的预测性能优于 BUN 或 Cr，受试者工作特征曲线下面积分别为 0.6，并且在年龄、性别、OSI、RTS、SAPS-II 和 SOFA 评分亚组中观察到这种关联。
BUN/Cr 比值可能是创伤相关 ARDS 住院死亡率的潜在生物标志物，有助于临床医生识别高危人群并实施临床干预。
