Usefulness of BUN/Albumin Ratio in Prediction of 28-day Mortality in Patients with Acute Cholangitis

Kang, Hyun Sol; Chung, Sung Phil; You, Je Sung; Joo, Young Seon; Kong, Tae Young; Ko, Dong Ryul; Hong, Jung Hwa; Park, Yoo Seok; Chung, Hyun Soo; Park, Incheol

J Korean Soc Emerg Med > Volume 26(6); 2015 > Article

Original 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.

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.
Method:
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.

Key words: Cholangitis, Blood urea nitrogen, Albumins, Prognosis