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J Korean Soc Emerg Med > Volume 33(3); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(3): 262-270.
위장관 출혈 환자의 예후를 예측하기 위한 blood urea nitrogen/albumin ratio 측정
조성봉1 , 이선화1 , 배성진2
1이화여자대학교 목동병원 응급의학과
2중앙대학교 광명병원 응급의학과
Usefulness of the blood urea nitrogen to serum albumin ratio as a prognostic factor of gastrointestinal bleeding patients
Seongbong Cho1 , SunHwa Lee1 , SungJin Bae2
1Department of Emergency Medicine, Ewha Womans University College of Medicine, Seoul, Korea
2Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
Correspondence  SungJin Bae ,Tel: 02-2222-1366, Fax: 02-2222-1379, Email: uzimuz85@gmail.com,
Received: June 25, 2021; Revised: September 29, 2021   Accepted: October 19, 2021.  Published online: June 30, 2022.
ABSTRACT
Objective:
Gastrointestinal (GI) bleeding is one of the most common reasons for people to visit the emergency department. Despite advances in treatments, the intensive care unit (ICU) admission rates due to GI bleeding are still high. Therefore, many scoring systems had been developed to screen patients who need active care. Among these scoring systems, the AIMS65 score, Glasgow-Blatchford score (GBS), and Pre-Rockall score (PRS) are known to be accurate risk assessment scoring models. A recent study has shown that hypoalbuminemia is related to poor prognosis in patients with GI bleeding. In this study, we compared the prognostic performance of the blood urea nitrogen to serum albumin ratio (B/A ratio) with the AIMS65, GBS, and PRS scores in patients with GI bleeding.
Method:
This is a retrospective cohort study of patients presenting with GI bleeding in the Seoul Regional Emergency room from February to December 2018. The baseline characteristics of these patients were obtained. The data were compared with the prevalence of ICU admission from the emergency department and in-hospital mortality. The B/A ratio, AIMS65, GBS, and PRS scores as predictors of ICU admission and in-hospital mortality were evaluated using the area under the receiver operating characteristic (AUROC) curve.
Results:
A total of 433 patients were included in this study. Of these, 354 (81.8%) were admitted to the hospital, 121 (27.9%) were admitted to the ICU, and 26 (6.0%) died during hospitalization. Multivariate logistic regression analysis revealed that the B/A ratio was a significant predictor of ICU admission and in-hospital mortality. The predicting ICU admission AUROC value of the B/A ratio was 0.735, and those of the AIMS65, GBS, and PRS scores were 0.763, 0.741, and 0.704, respectively. For predicting in-hospital mortality, the AUROC value of the B/A ratio was 0.758, and those of the AIMS65, GBS, and PRS scores were 0.826, 0.717, and 0.744, respectively.
Conclusion:
The B/A ratio is a useful tool for predicting the prognosis for patients with GI bleeding as are the AIMS65, GBS, and PRS score models.
Key words: Gastrointestinal hemorrhage; Albumin; Blood urea nitrogen; Mortality; Intensive care units; Emergency departments
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