The prognostic value of blood urea nitrogen/albumin ratio in patients with acute non-variceal upper gastrointestinal bleeding / 中华急诊医学杂志

ABSTRACT

Objective:To determine whether the blood urea nitrogen to serum albumin (B/A) ratio was a useful prognostic factor of mortality in the patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB).Methods:Totally 1 120 patients with acute upper gastrointestinal bleeding (VUGIB) admitted to the Emergency Department from January 2019 to December 2021 were prospectively and continuously collected and 449 eligible patients with acute non-varicose upper gastrointestinal tract were finally enrolled. The clinical data, laboratory tests and endoscopic results of the patients were recorded, and the data from the 30-day survival group and the non-survival group were compared and analyzed.Results:Significant differences were observed in age, mean arterial pressure, pulse rate, albumin levels, total protein levels, blood urea nitrogen levels, glucose, Glasgow-Blatchford score (GBS), Rockall, and AIMS65 scores between the survival and non-survival groups (all P <0.05). The B/A ratio in the non-survival group was significantly higher than that in the survival group [(24.9 ± 16.4) vs. (9.0 ± 8.6) mg/g, P<0.001]. Receiver operating characteristic (ROC) curve showed that the best cutoff value of B/A ratio for predicting 30-day death was 32.08 mg/g, with a sensitivity of 0.776 and specificity of 0.823. There was a significant difference in the 30-day Kaplan-Meier survival curve between patients with B/A ratio ≥32.08 mg/g and those with B/A ratio <32.08 mg/g (Log Rank 32.229, P<0.001). Multivariate logistic regression analysis revealed that the B/A ratio (≥32.08 mg/g) was associated with 30-day mortality ( OR=4.87, 95% CI 1.94-6.85, P<0.001). Area under the ROC curve (AUC) for B/A ratio, GBS, Rockall and AIMS65 scores for predicting 30-day mortality were 0.855 (95% CI 0.807-0.902), 0.849 (95% CI 0.796-0.901), 0.657 (95% CI 0.576-0.737), and 0.828 (95% CI 0.774-0.883), respectively. Conclusions:The B/A ratio is a simple but potentially useful prognostic factor of mortality in the ANVUGIB patients.