Evidence map›Paper›PMID 40990656›Full record

Observational studyInternational journal of surgery (London, England)2026

Blood urea nitrogen to albumin ratio as a robust predictor of in-hospital mortality in patients with predicted severe acute pancreatitis: a retrospective multicenter observational study.

Maobin Kuang, Yaoyu Zou, Yuting Lei, Cong He, Nianshuang Li, Ling Ding, Huijie Zhang, Yupeng Lei, Xin Huang, Huifang Xiong and 7 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Maobin KuangDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Yaoyu ZouDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Yuting LeiDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Cong HeDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Nianshuang LiDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Ling DingDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Huijie ZhangThe First Clinical Medical College of Nanchang University, Nanchang, Jiangxi Province, China.
Yupeng LeiDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Xin HuangDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Huifang XiongDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Lingyu LuoDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Liang XiaDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Wenhua HeDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Nonghua LvDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Wenjian MaoDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
Lu KeDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
Yin ZhuDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.ORCID 0000-0002-7561-2306

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite the established role of blood urea nitrogen-to-albumin ratio (BAR) in critical care, its prognostic value in acute pancreatitis remains unvalidated. This multicenter study assessed BAR's accuracy as an admission biomarker for predicting in-hospital mortality in predicted severe acute pancreatitis (SAP) cases.

methodsThis retrospective study enrolled 5384 patients from the LOCAL cohort and 494 patients from a multicenter double-blind randomized controlled trial (TRACE cohort), all of whom were predicted to have SAP (APACHE II ≥8) upon admission. Cox regression models were employed in two independent cohorts to explore the association between BAR and the risk of in-hospital mortality in subjects, and a restricted cubic spline regression was further constructed. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve was determined to evaluate the predictive capacity of BAR, blood urea nitrogen (BUN), albumin (ALB) and traditional scoring systems (APACHE II, SIRS, and BISAP) for in-hospital mortality. Time-dependent ROC analysis was also performed to assess the predictive performance of BUN and BAR at multiple time points.

resultsIn the LOCAL and TRACE cohorts, 320 (5.94%) and 39 (7.89%) patients died during hospitalization, respectively. Multivariable Cox regression models showed a significant positive association between BAR and the risk of in-hospital mortality [HR: LOCAL 1.23 (1.16-1.31); TRACE 1.33 (1.01-1.76)], while the restricted cubic spline analysis suggested a potential nonlinear relationship ( P for nonlinearity < 0.001). In prognostic prediction, BAR demonstrated significantly better performance than traditional scoring systems, BUN and ALB, and showed high accuracy in predicting outcomes for patients with biliary acute pancreatitis (AP) in both cohorts (area under the curve: LOCAL 0.8696; TRACE 0.8633). Additionally, time-dependent ROC analysis revealed that BAR demonstrated superior accuracy and stability in predicting mortality risk at 3, 5, 7, 9, 14, 28, 60, and 90 days, compared to BUN alone.

conclusionThis study is the first to demonstrate that BAR significantly improves the predictive accuracy of BUN and ALB for in-hospital mortality in predicted SAP patients, with particular effectiveness in predicting outcomes for biliary AP patients.

Indexed as

Blood Urea NitrogenHospital MortalityPancreatitisSerum AlbuminAdultAgedBiomarkersFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesROC CurveBiomarkersSerum AlbuminBARin-hospital mortalitypredicted severe acute pancreatitispredictiontime-dependent ROC

Identifiers

PMID40990656
PMCPMC12825864

What Socratic holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.