https://doi.org/10.4081/monaldi.2021.2091
Role of blood urea nitrogen and serum albumin ratio in predicting severity of community acquired pneumonia (CAP)
Submitted: September 18, 2021
Accepted: November 22, 2021
Published: December 3, 2021
Accepted: November 22, 2021
Abstract Views: 2548
PDF: 894
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Blood urea nitrogen and serum albumin levels are independent risk factors for poor clinical outcome in CAP. However, there is a paucity in the literature on the role of Blood urea nitrogen and albumin ratio(B/A) in CAP. This was a prospective observational study in which 112 admitted patients with the diagnosis of CAP underwent routine blood examinations, ABG, procalcitonin and Chest X-ray. Univariate analysis among various risk factors, CURB-65 scores, blood parameters including B/A ratios and clinical outcomes were carried out followed by multiple logistic regression. Cox regression was done to look at B/A values and time to mortality. In the logistic regression, age, CURB -65 score, B/A ratio and procalcitonin came out to be independent risk factors for ICU admission and mortality. Odds ratio of B/A in predicting mortality and ICU admission came out to be 67.8 (49.2-95.4) and 11.2 (8.4-14), respectively. Cox regression showed B/A values were also found to have a statistically significant relationship with time to mortality (p=0.001). B/A ratio has the potential to become a veritable predictor of poor clinical outcomes in patients with CAP.
GBD 2016 Lower Respiratory Infections Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis 2018;18:1191-210.
Ramirez JA, Wiemken TL, Peyrani P, et al. Adults hospitalized with pneumonia in the United States: Incidence, epidemiology, and mortality. Clin Infect Dis 2017;65:1806-12.
DOI: https://doi.org/10.1093/cid/cix647
Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 2003;58:377–82.
DOI: https://doi.org/10.1136/thorax.58.5.377
Rudolph JL, Zanin NM, Jones RN, et al. Hospitalization in community-dwelling persons with Alzheimer’s disease: frequency and causes. J Am Geriatr Soc 2010;58:1542–8.
DOI: https://doi.org/10.1111/j.1532-5415.2010.02924.x
Shah BA, Ahmed W, Dhobi GN, et al. Validity of pneumonia severity index and CURB-65 severity scoring systems in community acquired pneumonia in an Indian setting. Indian J Chest Dis Allied Sci 2010;52:9–17.
DOI: https://doi.org/10.1016/S0012-3692(16)47639-7
Potgieter PD, Hammond JM. The intensive care management, mortality, and prognostic indicators in severe community-acquired pneumococcal pneumonia. Intensive Care Med 1996; 22:1301–6.
DOI: https://doi.org/10.1007/BF01709542
Lee JH, Kim J, Kim K, et al. Albumin and C-reactive protein have prognostic significance in patients with community-acquired pneumonia. J Crit Care 2011;26:287-94.
DOI: https://doi.org/10.1016/j.jcrc.2010.10.007
Ugajin M, Yamaki K, Iwamura N, et al. Blood urea nitrogen to serum albumin ratio independently predicts mortality and severity of community-acquired pneumonia. Int J Gen Med 2012;5:583-9.
DOI: https://doi.org/10.2147/IJGM.S33628
Akpinar EE, Hoşgün D, Doğanay B, Gülhan M. The role of albumin level and blood urea nitrogen/albumin ratio in prediction of prognosis of community acquired pneumonia. J Pulm Respir Med 2013;3:5.
DOI: https://doi.org/10.4172/2161-105X.1000159
Beier K, Eppanapally S, Bazick HS, et al. Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of "normal" creatinine. Crit Care Med 2011;39:305-13.
DOI: https://doi.org/10.1097/CCM.0b013e3181ffe22a
Schrier RW. Body fluid volume regulation in health and disease: a unifying hypothesis. Ann Intern Med 1990;113:155-9.
DOI: https://doi.org/10.7326/0003-4819-113-2-155
Conte G, Dal Canton A, Terribile M, et al. Renal handling of urea in subjects with persistent azotemia and normal renal function. Kidney Int 1987;32:721-7.
DOI: https://doi.org/10.1038/ki.1987.266
Schrier RW. Blood urea nitrogen and serum creatinine: not married in heart failure. Circ Heart Fail 2008;1:2-5.
DOI: https://doi.org/10.1161/CIRCHEARTFAILURE.108.770834
Farr BM, Sloman AJ, Fisch MJ. Predicting death in patients hospitalized for community-acquired pneumonia. Ann Intern Med 1991;115:428–36.
DOI: https://doi.org/10.7326/0003-4819-115-6-428
Raz R, Dyachenko P, Levy Y, et al. A predictive model for the management of community-acquired pneumonia. Infection 2003;31:3-8.
DOI: https://doi.org/10.1007/s15010-002-2083-4
Jyothi R, Basavaraj B, Gurupadappa K. The prognostic implication of serum albumin and BUN/Albumin ratio in assessing severity and mortality in community acquired pneumonia (CAP). Int J Clin Biochem Res 2019;6:79-81.
DOI: https://doi.org/10.18231/2394-6377.2019.0020
Dai RX, Kong QH, Mao B, et al. The mortality risk factor of community acquired pneumonia patients with chronic obstructive pulmonary disease: a retrospective cohort study. BMC Pulm Med 2018;18:12.
DOI: https://doi.org/10.1186/s12890-018-0587-7
Restrepo MI, Mortensen EM, Pugh JA, Anzueto A. COPD is associated with increased mortality in patients with community-acquired pneumonia. Eur Respir J 2006;28:346-51.
DOI: https://doi.org/10.1183/09031936.06.00131905
India State-Level Disease Burden Initiative CRD Collaborators. The burden of chronic respiratory diseases and their heterogeneity across the states of India: the Global Burden of Disease Study 1990-2016. Lancet Glob Health 2018;6:e1363-74.
How to Cite
Agarwal, Mehul, Madhur Joshi, Manohar Gupta, Neha Bharti, Amartya Chakraborti, and Maldev Sonigra. 2021. “Role of Blood Urea Nitrogen and Serum Albumin Ratio in Predicting Severity of Community Acquired Pneumonia (CAP)”. Monaldi Archives for Chest Disease 92 (3). https://doi.org/10.4081/monaldi.2021.2091.
Copyright (c) 2021 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Marco Ambrosetti, Patrick Doherty, Pompilio Faggiano, Ugo Corrà, Carlo Vigorito, Dominique Hansen, Patrizio Sarto, Ana Abreu, Roberto F.E. Pedretti, Characteristics of structured physical training currently provided in cardiac patients: insights from the Exercise Training in Cardiac Rehabilitation (ETCR) Italian survey , Monaldi Archives for Chest Disease: Vol. 87 No. 1 (2017)
- Lucrezia De Michele, Paola Pierucci, Guido Giovannetti, Michele De Ceglie, Michela Dimitri, Alessandra Mirabile, Vitaliano Quaranta, Arnaldo Scardapane, Carlo D'Agostino, Giovanna Elisiana Carpagnano, Post severe COVID-19 infection lung damages study. The experience of early three months multidisciplinary follow-up , Monaldi Archives for Chest Disease: Vol. 92 No. 4 (2022)
- Ruby Joseph, Kavitha Venkatnarayan, Ashitha Nanaiah, Priya Ramachandran, A case of hoarseness of voice following COVID-19 infection , Monaldi Archives for Chest Disease: Vol. 93 No. 4 (2023)
You may also start an advanced similarity search for this article.
