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J Korean Soc Emerg Med > Volume 26(6); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(6): 491-499.
응급진료센터에 내원한 급성 담관염 환자에서 혈액요소질소/알부민 비를 이용한 28일 사망률 예측의 유용성
강현솔1, 정성필1, 유제성1, 주영선1, 공태영1, 고동률1, 홍정화2, 박유석1, 정현수1, 박인철1
1연세대학교 의과대학 응급의학교실
2연세대학교 의과대학 연구부 통계지원팀
Usefulness of BUN/Albumin Ratio in Prediction of 28-day Mortality in Patients with Acute Cholangitis
Hyun Sol Kang1, Sung Phil Chung1, Je Sung You1, Young Seon Joo1, Tae Young Kong1, Dong Ryul Ko1, Jung Hwa Hong2, Yoo Seok Park1, Hyun Soo Chung1, Incheol Park1
1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
2Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
Correspondence  Je Sung You ,Tel: 02) 2019-3030, Fax: 02) 2019-4820, Email: youjsmd@yuhs.ac,
Received: July 16, 2015; Revised: July 20, 2015   Accepted: September 10, 2015.  Published online: December 30, 2015.
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.
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.
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.
The ratio of BUN to albumin on ED admission is a promising prognostic marker of 28-day mortality in patients with acute cholangitis.
Key words: Cholangitis, Blood urea nitrogen, Albumins, Prognosis
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