The prognostic value of blood urea nitrogen to albumin ratio in patients with sepsis in the emergency department

Zhang Ying; Wang Junyu; Wei Bing; Hu Le; Wang Jia; Dong Hongmeng; Ji Wenqing; Wu Junyuan

doi:10.3760/j.issn.1673-4777.2024.07.015

Abstract：Objective To explore the prognostic value of blood urea nitrogen to albumin ratio in patients with sepsis in the emergency department.Methods The basic information and laboratory examination data of 313 patients with sepsis treated in the emergency room of Beijing Chao-Yang Hospital,Capital Medical University from March 2021 to March 2022 were collected by retrospective observation method.The patients were divided into survival group(229 cases)and death group(84 cases)according to whether they died during the treatment in the hospital.The clinical and laboratory data of the two groups were compared,and the risk factors of death during hospitalization were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of BAR in patients with sepsis.Results The age,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,heart rate,and proportion of cerebral infarction in the death group were significantly higher than those in the survival group,while systolic blood pressure,diastolic blood pressure,and proportion of chronic obstructive pulmonary diseasein the death group were lower than those in the survival group(all P＜0.05).The white blood cell count,absolute value of neutrophils,CRP,procalcitonin,blood urea nitrogen,aspartate aminotransferase,and BAR in the death group were higher than those in the survival group,while the absolute value of lymphocytes and albumin levels were lower than those in the survival group(all P＜0.05).Multivariate Logistic regression analysis showed that BAR(P=0.025)and APACHE Ⅱ score(P＜0.001)were independent risk factors for in-hospital death of sepsis patients.The ROC curve analysis results showed that the area under the curve(AUC)of BAR for predicting the death of sepsis patients during hospitalization was 0.728,the AUC for APACHE Ⅱ score was 0.814,and the AUC for BAR+APACHE Ⅱ score was 0.824.The combined predictive effect was better than BAR alone.The combination of BAR and APACHE Ⅱ scores had good sensitivity and specificity(sensitivity of 77.4％and specificity of 75.5％).Conclusions BAR,APACHE Ⅱ scores are independent risk factors for the prognosis of patients with sepsis.BAR has moderate predictive power and high specificity for the prognosis of patients with sepsis in the emergency department.Compared with BAR alone,BAR combined with APACHE Ⅱ score has better predictive power,with better sensitivity and higher specificity.