Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU.
Blood urea nitrogen (BUN) was reported to be associated with mortality in heart failure patients. We aimed to evaluate admission BUN concentration in a heterogeneous critically ill patient collective admitted to an intensive care unit (ICU) for prognostic relevance.A total of 4176 medical patients (...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5784990?pdf=render |
| _version_ | 1819064947711148032 |
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| author | Okan Arihan Bernhard Wernly Michael Lichtenauer Marcus Franz Bjoern Kabisch Johanna Muessig Maryna Masyuk Alexander Lauten Paul Christian Schulze Uta C Hoppe Malte Kelm Christian Jung |
| author_facet | Okan Arihan Bernhard Wernly Michael Lichtenauer Marcus Franz Bjoern Kabisch Johanna Muessig Maryna Masyuk Alexander Lauten Paul Christian Schulze Uta C Hoppe Malte Kelm Christian Jung |
| author_sort | Okan Arihan |
| collection | DOAJ |
| description | Blood urea nitrogen (BUN) was reported to be associated with mortality in heart failure patients. We aimed to evaluate admission BUN concentration in a heterogeneous critically ill patient collective admitted to an intensive care unit (ICU) for prognostic relevance.A total of 4176 medical patients (67±13 years) admitted to a German ICU between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. Association of admission BUN and both intra-hospital and long-term mortality were investigated by Cox regression. An optimal cut-off was calculated by means of the Youden-Index.Patients with higher admission BUN concentration were older, clinically sicker and had more pronounced laboratory signs of multi-organ failure including kidney failure. Admission BUN was associated with adverse long-term mortality (HR 1.013; 95%CI 1.012-1.014; p<0.001). An optimal cut-off was calculated at 28 mg/dL which was associated with adverse outcome even after correction for APACHE2 (HR 1.89; 95%CI 1.59-2.26; p<0.001), SAPS2 (HR 1.85; 95%CI 1.55-2.21; p<0.001) and several parameters including creatinine in an integrative model (HR 3.34; 95%CI 2.89-3.86; p<0.001). We matched 614 patients with admission BUN >28 mg/dL to case-controls ≤ 28mg/dL corrected for APACHE2 scores: BUN above 28 mg/dL remained associated with adverse outcome in a paired analysis with the difference being 5.85% (95%CI 1.23-10.47%; p = 0.02).High BUN concentration at admission was robustly associated with adverse outcome in critically ill patients admitted to an ICU, even after correction for co-founders including renal failure. BUN might constitute an independent, easily available and important parameter for risk stratification in the critically ill. |
| first_indexed | 2024-12-21T15:38:40Z |
| format | Article |
| id | doaj.art-9899a1e047b744219af48103029921a7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T15:38:40Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-9899a1e047b744219af48103029921a72022-12-21T18:58:34ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01131e019169710.1371/journal.pone.0191697Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU.Okan ArihanBernhard WernlyMichael LichtenauerMarcus FranzBjoern KabischJohanna MuessigMaryna MasyukAlexander LautenPaul Christian SchulzeUta C HoppeMalte KelmChristian JungBlood urea nitrogen (BUN) was reported to be associated with mortality in heart failure patients. We aimed to evaluate admission BUN concentration in a heterogeneous critically ill patient collective admitted to an intensive care unit (ICU) for prognostic relevance.A total of 4176 medical patients (67±13 years) admitted to a German ICU between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. Association of admission BUN and both intra-hospital and long-term mortality were investigated by Cox regression. An optimal cut-off was calculated by means of the Youden-Index.Patients with higher admission BUN concentration were older, clinically sicker and had more pronounced laboratory signs of multi-organ failure including kidney failure. Admission BUN was associated with adverse long-term mortality (HR 1.013; 95%CI 1.012-1.014; p<0.001). An optimal cut-off was calculated at 28 mg/dL which was associated with adverse outcome even after correction for APACHE2 (HR 1.89; 95%CI 1.59-2.26; p<0.001), SAPS2 (HR 1.85; 95%CI 1.55-2.21; p<0.001) and several parameters including creatinine in an integrative model (HR 3.34; 95%CI 2.89-3.86; p<0.001). We matched 614 patients with admission BUN >28 mg/dL to case-controls ≤ 28mg/dL corrected for APACHE2 scores: BUN above 28 mg/dL remained associated with adverse outcome in a paired analysis with the difference being 5.85% (95%CI 1.23-10.47%; p = 0.02).High BUN concentration at admission was robustly associated with adverse outcome in critically ill patients admitted to an ICU, even after correction for co-founders including renal failure. BUN might constitute an independent, easily available and important parameter for risk stratification in the critically ill.http://europepmc.org/articles/PMC5784990?pdf=render |
| spellingShingle | Okan Arihan Bernhard Wernly Michael Lichtenauer Marcus Franz Bjoern Kabisch Johanna Muessig Maryna Masyuk Alexander Lauten Paul Christian Schulze Uta C Hoppe Malte Kelm Christian Jung Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. PLoS ONE |
| title | Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. |
| title_full | Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. |
| title_fullStr | Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. |
| title_full_unstemmed | Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. |
| title_short | Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU. |
| title_sort | blood urea nitrogen bun is independently associated with mortality in critically ill patients admitted to icu |
| url | http://europepmc.org/articles/PMC5784990?pdf=render |
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