Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China.
Ultrasonic Medicine, Public Health Clinical Center of Chengdu, Chengdu, 610000, Sichuan, China.
Sci Rep. 2024 Jul 16;14(1):16430. doi: 10.1038/s41598-024-65622-z.
The relationship between blood urea nitrogen to albumin ratio (BAR) and the prognosis of patients with tuberculosis (TB) complicated by sepsis remains unclear. This study aimed to explore the association between BAR and overall patient prognosis. This was a retrospective cohort study of patients with TB complicated by sepsis who were admitted to the intensive care unit (ICU) of the Public Health Clinical Center of Chengdu between January 2019 and February 2023. The relationship between BAR values and prognosis in these patients was investigated using multivariate Cox regression, stratified analysis with interaction, restricted cubic spline (RCS), and threshold effect analysis. Sensitivity analyses were conducted to assess the robustness of the results. Our study included 537 TB patients complicated by sepsis admitted in the ICU, with a median age of 63.0 (48.0, 72.0) years; 76.7% of whom were men. The multivariate-restricted cubic spline analysis showed a non-linear association between BAR and patient prognosis. In the threshold analysis, we found that TB patients complicated by sepsis and a BAR < 7.916 mg/g had an adjusted hazard ratio (HR) for prognosis of 1.163 (95% CI 1.038-1.303; P = 0.009). However, when the BAR was ≥ 7.916 mg/g, there was no significant increase in the risk of death. The results of the sensitivity analysis were stable.
血尿素氮与白蛋白比值（BAR）与结核病（TB）合并脓毒症患者预后的关系尚不清楚。本研究旨在探讨 BAR 与患者总体预后的关系。这是一项回顾性队列研究，纳入了 2019 年 1 月至 2023 年 2 月期间在成都市公共卫生临床医疗中心重症监护病房（ICU）住院的合并脓毒症的 TB 患者。使用多变量 Cox 回归、分层分析与交互作用、限制性立方样条（RCS）和阈值效应分析来研究这些患者的 BAR 值与预后之间的关系。进行敏感性分析以评估结果的稳健性。我们的研究纳入了 537 例 ICU 住院的合并脓毒症的 TB 患者，中位年龄为 63.0（48.0，72.0）岁；76.7%为男性。多变量限制立方样条分析显示 BAR 与患者预后之间存在非线性关系。在阈值分析中，我们发现 BAR<7.916mg/g 的合并脓毒症的 TB 患者的预后调整后危险比（HR）为 1.163（95% CI 1.038-1.303；P=0.009）。然而，当 BAR≥7.916mg/g 时，死亡风险无显著增加。敏感性分析结果稳定。
