Xia Hao, Lin Jinzhan, Liu Minchao, Lai Jiawei, Yang Zhaobin, Qiu Luzhen
Department of Medicine Intensive Care Unit, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China.
Department of Hepatobiliary Surgery, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China.
Sci Rep. 2025 Apr 17;15(1):13327. doi: 10.1038/s41598-025-97891-7.
Blood urea nitrogen (BUN) and serum albumin (ALB) are strongly associated with the prognosis in acute pancreatitis (AP). The BUN/ALB ratio (BAR) reflects renal, nutritional, inflammatory, and endothelial functions. In this study, we investigated the association between the BAR and all-cause mortality in critically ill patients with AP. Using data from the Medical Information Market for Intensive Care (MIMIC-IV) database, we conducted a retrospective cohort analysis. The relationship between BAR and mortality was assessed through Kaplan-Meier survival curves, restricted cubic spline models, and multivariable Cox proportional hazards regression. The predictive capacity of BAR for 30-day and 1-year mortality was evaluated using receiver operating characteristic analysis. Our study included 780 participants, with 30-day and 1-year mortality rates of 12.6% and 23.6%, respectively. Higher BAR values were associated with poorer survival outcomes. BAR demonstrated superior predictive performance achieving an area under the curve of 0.74, surpassing BUN, ALB, and SOFA scores. The Cox model indicated a significant independent association between elevated BAR and increased mortality risk, with hazard ratios of 1.43 (95% CI 1.20-1.70) for 30-day mortality and 1.37 (95% CI 1.17-1.60) for 1-year mortality. Stratified and sensitivity analyses confirmed the robustness of these findings. Our results suggest that elevated BAR is associated with poor prognosis in critically ill patients with AP and may serve as a valuable tool for early risk stratification and for assessing both short- and long-term prognosis.
血尿素氮（BUN）和血清白蛋白（ALB）与急性胰腺炎（AP）的预后密切相关。BUN/ALB比值（BAR）反映肾脏、营养、炎症和内皮功能。在本研究中，我们调查了BAR与危重症AP患者全因死亡率之间的关联。利用重症监护医学信息市场（MIMIC-IV）数据库的数据，我们进行了一项回顾性队列分析。通过Kaplan-Meier生存曲线、限制性立方样条模型和多变量Cox比例风险回归评估BAR与死亡率之间的关系。使用受试者工作特征分析评估BAR对30天和1年死亡率的预测能力。我们的研究纳入了780名参与者，30天和1年死亡率分别为12.6%和23.6%。较高的BAR值与较差的生存结果相关。BAR表现出卓越的预测性能，曲线下面积达到0.74，超过了BUN、ALB和序贯器官衰竭评估（SOFA）评分。Cox模型表明，BAR升高与死亡风险增加之间存在显著的独立关联，30天死亡率的风险比为1.43（95%置信区间1.20-1.70），1年死亡率的风险比为1.37（95%置信区间1.17-1.60）。分层分析和敏感性分析证实了这些结果的稳健性。我们的结果表明，BAR升高与危重症AP患者的不良预后相关，可能是早期风险分层以及评估短期和长期预后的有价值工具。
