Elevated BUN Upon Admission as a Predictor of in-Hospital Mortality Among Patients with Acute Exacerbation of COPD : A Secondary Analysis of Multicenter Cohort Study
© 2023 Zhang et al..
Background: High blood urea nitrogen (BUN) is observed in a subset of patients with acute exacerbation of COPD (AECOPD) and may be linked to clinical outcome, but findings from previous studies have been inconsistent.
Methods: We performed a retrospective analysis of patients prospectively enrolled in the MAGNET AECOPD Registry study (ChiCTR2100044625). Receiver operating characteristic (ROC) was used to determine the level of BUN that discriminated survivors and non-survivors. Univariate and multivariate Cox proportional hazards regression analyses were performed to assess the impact of BUN on adverse outcomes.
Results: Overall, 13,431 consecutive inpatients with AECOPD were included in this study, of whom 173 died, with the mortality of 1.29%. The non-survivors had higher levels of BUN compared with the survivors [9.5 (6.8-15.3) vs 5.6 (4.3-7.5) mmol/L, P < 0.001]. ROC curve analysis showed that the optimal cutoff of BUN level was 7.30 mmol/L for in-hospital mortality (AUC: 0.782; 95% CI: 0.748-0.816; P < 0.001). After multivariate analysis, BUN level ≥7.3 mmol/L was an independent risk factor for in-hospital mortality (HR = 2.099; 95% CI: 1.378-3.197, P = 0.001), also for invasive mechanical ventilation (HR = 1.540; 95% CI: 1.199-1.977, P = 0.001) and intensive care unit admission (HR = 1.344; 95% CI: 1.117-1.617, P = 0.002). Other independent prognostic factors for in-hospital mortality including age, renal dysfunction, heart failure, diastolic blood pressure, pulse rate, PaCO2 and D-dimer.
Conclusion: BUN is an independent risk factor for in-hospital mortality in inpatients with AECOPD and may be used to identify serious (or severe) patients and guide the management of AECOPD.
Clinical Trial Registration: MAGNET AECOPD; Chinese Clinical Trail Registry NO.: ChiCTR2100044625; Registered March 2021, URL: http://www.chictr.org.cn/showproj.aspx?proj=121626.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
|---|---|
| Enthalten in: |
International journal of chronic obstructive pulmonary disease - 18(2023) vom: 17., Seite 1445-1455 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhang, Jiarui [VerfasserIn] |
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| Links: |
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| Themen: |
AECOPD |
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| Anmerkungen: |
Date Completed 21.07.2023 Date Revised 17.09.2023 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.2147/COPD.S412106 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359662935 |
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| 100 | 1 | |a Zhang, Jiarui |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Elevated BUN Upon Admission as a Predictor of in-Hospital Mortality Among Patients with Acute Exacerbation of COPD |b A Secondary Analysis of Multicenter Cohort Study |
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| 500 | |a Date Completed 21.07.2023 | ||
| 500 | |a Date Revised 17.09.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 Zhang et al. | ||
| 520 | |a Background: High blood urea nitrogen (BUN) is observed in a subset of patients with acute exacerbation of COPD (AECOPD) and may be linked to clinical outcome, but findings from previous studies have been inconsistent | ||
| 520 | |a Methods: We performed a retrospective analysis of patients prospectively enrolled in the MAGNET AECOPD Registry study (ChiCTR2100044625). Receiver operating characteristic (ROC) was used to determine the level of BUN that discriminated survivors and non-survivors. Univariate and multivariate Cox proportional hazards regression analyses were performed to assess the impact of BUN on adverse outcomes | ||
| 520 | |a Results: Overall, 13,431 consecutive inpatients with AECOPD were included in this study, of whom 173 died, with the mortality of 1.29%. The non-survivors had higher levels of BUN compared with the survivors [9.5 (6.8-15.3) vs 5.6 (4.3-7.5) mmol/L, P < 0.001]. ROC curve analysis showed that the optimal cutoff of BUN level was 7.30 mmol/L for in-hospital mortality (AUC: 0.782; 95% CI: 0.748-0.816; P < 0.001). After multivariate analysis, BUN level ≥7.3 mmol/L was an independent risk factor for in-hospital mortality (HR = 2.099; 95% CI: 1.378-3.197, P = 0.001), also for invasive mechanical ventilation (HR = 1.540; 95% CI: 1.199-1.977, P = 0.001) and intensive care unit admission (HR = 1.344; 95% CI: 1.117-1.617, P = 0.002). Other independent prognostic factors for in-hospital mortality including age, renal dysfunction, heart failure, diastolic blood pressure, pulse rate, PaCO2 and D-dimer | ||
| 520 | |a Conclusion: BUN is an independent risk factor for in-hospital mortality in inpatients with AECOPD and may be used to identify serious (or severe) patients and guide the management of AECOPD | ||
| 520 | |a Clinical Trial Registration: MAGNET AECOPD; Chinese Clinical Trail Registry NO.: ChiCTR2100044625; Registered March 2021, URL: http://www.chictr.org.cn/showproj.aspx?proj=121626 | ||
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| 650 | 4 | |a blood urea nitrogen | |
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| 650 | 4 | |a mortality | |
| 700 | 1 | |a Qin, Yichun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Luo, Yuanming |e verfasserin |4 aut | |
| 700 | 1 | |a Wei, Hailong |e verfasserin |4 aut | |
| 700 | 1 | |a Ge, Huiqing |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Hui-Guo |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jianchu |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Xianhua |e verfasserin |4 aut | |
| 700 | 1 | |a Pan, Pinhua |e verfasserin |4 aut | |
| 700 | 1 | |a Yi, Mengqiu |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Lina |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Aili, Adila |e verfasserin |4 aut | |
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| 700 | 1 | |a Yi, Qun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Haixia |e verfasserin |4 aut | |
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