Elevated Blood Urea Nitrogen-to-Serum Albumin Ratio as a Factor That Negatively Affects the Mortality of Patients with Hospital-Acquired Pneumonia

الملخص EN

This study aimed to evaluate the factors that affect 30-day mortality of patients with HAP.

The data used in this study were collected from all HAP occurred in our hospital between January 2014 and December 2017.

A total of 1158 cases were included.

150 (13.0%) of whom died within 30 days.

This reported mortality identified by the univariate Cox regression analysis is found to have been affected by the following factors: age greater than 70 years, presence of diabetes mellitus and chronic obstructive pulmonary disease, gastric tube intubation, administration of proton-pump inhibitor, blood albumin level less than 30 g/l, elevated neutrophil-to-lymphocyte ratio, antibiotics therapy in the preceding 90 days, intensive care unit (ICU) admission, blood lymphocyte count less than 0.8 × 109/L, elevated blood urea nitrogen/albumin (BUN/ALB) level, and presence of multidrug-resistant (MDR) pathogens.

In the second multivariate analysis, administration of proton-pump inhibitor, administration of antibiotics in the preceding 90 days, ICU admission, blood lymphocyte count less than 0.8 × 109/L, elevated BUN/ALB level, and presence of MDR pathogens were still associated with 30-day mortality.

The area under the receiver operating characteristic curves in the BUN/ALB predicting 30-day mortality due to HAP was 0.685.

A high BUN/ALB was significantly associated with a worse survival than a low BUN/ALB P<0.001.

Therefore, an elevated BUN/ALB level is a risk factor for mortality on patients with HAP.