ArticleEuropean journal of medical research2025
The association between blood urea nitrogen to albumin ratio and 28-day ICU mortality in sepsis patients: a retrospective cohort study.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- The Association Between Systemic Inflammatory and Metabolic Indices and Early Adverse Clinical Outcomes in Adult Patients Admitted to the Post-anaesthesia Care Unit: A Retrospective Observational Study.Turkish journal of anaesthesiology and reanimation · 2026Article
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4 authors.
Funding
Abstract
backgroundSepsis remains a leading cause of mortality in intensive care unit (ICU) patients, with mortality rates up to 30%. While the Blood Urea Nitrogen (BUN) to Albumin ratio has been associated with outcomes in various conditions, the dose-response relationship between this ratio and mortality in sepsis patients remains unclear.
methodsThis retrospective cohort study analyzed 9,783 sepsis patients from the eICU Collaborative Research Database. The relationship between BUN/Albumin ratio and 28-day ICU mortality was examined using multivariate logistic regression and threshold effect analysis. Models were adjusted for demographics, clinical parameters, comorbidities, and laboratory values. Threshold effect analysis was performed using two-piecewise linear regression.
resultsA non-linear relationship was identified between the BUN/Albumin ratio and 28-day ICU mortality, with a threshold at 20.91 mg/g (95% CI 17.19-26.90). Below this threshold, each unit difference in the ratio was associated with higher mortality odds (OR: 1.06, 95% CI 1.04-1.08, P < 0.0001). Above the threshold, the association persisted but is markedly attenuated (OR: 1.01, 95% CI 1.00-1.02). This relationship remained robust after adjusting for potential confounders and in sensitivity analyses.
conclusionsA nonlinear association was observed between the BUN/Albumin ratio and 28-day ICU mortality among patients with sepsis, with an inflection point established at 20.91 mg/g. This readily accessible parameter has the potential to aid in early risk stratification within the ICU setting. Additional research is warranted to validate these findings.
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