Association Between Blood Urea Nitrogen to Serum Albumin Ratio and In-hospital Mortality in Critical Patients with Diabetic Ketoacidosis: a Retrospective Analysis of the EICU Database

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2024 Jul 12

PMID 38994011

Authors

Hua Chen

Yufei Wang

Rong Ji

Minghui Li

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to investigate the association between blood urea nitrogen to serum albumin ratio (BAR) and the risk of in-hospital mortality in patients with diabetic ketoacidosis.

Methods: A total of 3,962 diabetic ketoacidosis patients from the eICU Collaborative Research Database were included in this analysis. The primary outcome was in-hospital death.

Results: Over a median length of hospital stay of 3.1 days, 86 in-hospital deaths were identified. One unit increase in LnBAR was positively associated with the risk of in-hospital death (hazard ratio [HR], 1.82 [95% CI, 1.42-2.34]). Furthermore, a nonlinear, consistently increasing correlation between elevated BAR and in-hospital mortality was observed (P for trend =0.005 after multiple-adjusted). When BAR was categorized into quartiles, the higher risk of in-hospital death (multiple-adjusted HR, 1.99 [95% CI, (1.1-3.6)]) was found in participants in quartiles 3 to 4 (BAR≥6.28) compared with those in quartiles 1 to 2 (BAR<6.28). In the subgroup analysis, the LnBAR-hospital death association was significantly stronger in participants without kidney insufficiency (yes versus no, P-interaction=0.023).

Conclusion: There was a significant and positive association between BAR and the risk of in-hospital death in patients with diabetic ketoacidosis. Notably, the strength of this association was intensified among those without kidney insufficiency.

Citing Articles

Association Between Blood Urea Nitrogen/Albumin and the Incidence as Well as Progression of Type 2 Diabetes.

Liang Y, Zhou R, Jin C, Liang J, Wang X, Fan W Nutrients. 2025; 17(1.

PMID: 39796544 PMC: 11723113. DOI: 10.3390/nu17010113.

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