Usefulness of BUN/Albumin Ratio in Prediction of 28-day Mortality in Patients with Acute Cholangitis.
- Author:
Hyun Sol KANG
1
;
Sung Phil CHUNG
;
Je Sung YOU
;
Young Seon JOO
;
Tae Young KONG
;
Dong Ryul KO
;
Jung Hwa HONG
;
Yoo Seok PARK
;
Hyun Soo CHUNG
;
Incheol PARK
Author Information
1. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. youjsmd@yuhs.ac
- Publication Type:Original Article
- Keywords:
Cholangitis;
Blood urea nitrogen;
Albumins;
Prognosis
- MeSH:
Adult;
Albumins;
Blood Urea Nitrogen;
Cholangitis*;
Critical Illness;
Emergency Service, Hospital;
Humans;
Medical Records;
Mortality*;
Prognosis;
Proportional Hazards Models;
Retrospective Studies;
Risk Factors
- From:Journal of the Korean Society of Emergency Medicine
2015;26(6):491-499
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We evaluated the blood urea nitrogen (BUN)/albumin (B/A) ratio in patients with acute cholangitis to determine the prognostic significance of the B/A ratio as a marker of early mortality in critically ill patients with acute cholangitis. METHODS: We retrospectively analyzed medical records in two emergency departments (ED) and screened eligible adult patients who were admitted to the ED with acute cholangitis. The B/A ratio was evaluated as the BUN value divided by albumin level on each hospital day. The clinical outcome was mortality after 28 days. RESULTS: A total of 461 patients with acute cholangitis were included in this study. Multivariate Cox proportional hazard models showed that higher B/A ratio on ED admission (day 1) (Hazard Ratio (HR): 1.182; 95% Confidence Interval (CI): 1.076-1.298, p<0.001) and day 4 (HR: 1.192; 95% CI: 1.019-1.395, p=0.028) were independent risk factors for mortality at 28 days. Our study showed that the increased 28-day mortality was associated with a B/A ratio >6.83 on day 1 (HR: 4.065; 95% CI: 4.123-43.737, p<0.001) and a higher B/A ratio (>6.26) on day 4 (HR: 7.16; 95% CI: 1.412-36.333, p=0.018) in patients with acute cholangitis. Conclusion: The ratio of BUN to albumin on ED admission is a promising prognostic marker of 28-day mortality in patients with acute cholangitis. CONCLUSION: The ratio of BUN to albumin on ED admission is a promising prognostic marker of 28-day mortality in patients with acute cholangitis.
