Predictive value of the blood urea nitrogen to serum albumin ratio in sepsis among patients with acute-on-chronic liver failure
10.3760/cma.j.cn311365-20250407-00105
- VernacularTitle:血尿素氮与血清白蛋白比值对慢加急性肝衰竭患者脓毒症的预测价值
- Author:
Hejuan DU
1
;
Xueshi ZHOU
1
;
Tingting SU
1
;
Huijing FANG
1
;
Zhihan YAN
1
;
Yueping YAO
1
;
Xiaoye GUO
1
Author Information
1. 无锡市第五人民医院感染科，无锡 214000
- Publication Type:Journal Article
- Keywords:
Liver failure;
Sepsis;
Blood urea nitrogen to serum albumin ratio
- From:
Chinese Journal of Infectious Diseases
2025;43(6):332-338
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation and predictive value of the blood urea nitrogen to serum albumin ratio (BAR) in the development of sepsis among patients with acute-on-chronic liver failure (ACLF).Methods:A total of 410 patients diagnosed with ACLF who were admitted to Wuxi Fifth People′s Hospital between January 1st, 2020 and December 31st, 2024 were enrolled in this study. Demographic information, laboratory test indicators, and other clinical data were retrospectively analyzed. Participants were stratified into two groups using a 6∶4 allocation ratio, comprising a training set of 246 patients and a validation set of 164 patients, the clinical data of two groups were compared. Logistic regression was employed to evalute the influencing factors of sepsis during hospitalization in ACLF patients. Additionally, the predictive value of different factors for sepsis occurrence was evaluated using receiver-operating characteristic curve analysis. DeLong test was used to compare the area under the curve.Results:The comparison of baseline data between the training set and the validation set revealed no statistically significant differences (all P>0.05). A total of 197 sepsis cases were observed during the study period. Multivariate logistic regression analysis revealed that both BAR and the sequential organ failure assessment (SOFA) score were independent influencing factors for sepsis development in ACLF patients (odds ratio ( OR)=1.274, 95% confidence interval (95% CI) 1.075 to 1.510, P=0.005; OR=1.142, 95% CI 1.038 to 1.256, P=0.006). In the training set, the area under the curve (AUC) of BAR for predicting sepsis in ACLF patients was 0.802, which was superior to that of the SOFA score (AUC=0.706) ( Z=2.16, P=0.031). The validation set showed the predictive ability of BAR with an AUC of 0.726, which was superior to the SOFA score′s performance (AUC=0.606) ( Z=2.28, P=0.023). Conclusions:BAR could independently predict sepsis development in ACLF patients with significant prognostic value. BAR could be used as a clinically useful biomarker for sepsis risk stratification.
