Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Oct:48:33-37.
doi: 10.1016/j.ajem.2021.03.090. Epub 2021 Apr 5.

The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department

Kadir Küçükceran  1 , Mustafa Kürşat Ayrancı  2 , Abdullah Sadık Girişgin  2 , Sedat Koçak  2 , Zerrin Defne Dündar  2
Affiliations
Free PMC article
Observational Study

The role of the BUN/albumin ratio in predicting mortality in COVID-19 patients in the emergency department

Kadir Küçükceran et al. Am J Emerg Med. 2021 Oct.
Free PMC article

Abstract

Introduction: Due to the high mortality and spread rates of coronavirus disease 2019 (COVID-19), there are currently serious challenges in emergency department management. As such, we investigated whether the blood urea nitrogen (BUN)/albumin ratio (BAR) predicts mortality in the COVID-19 patients in the emergency department.

Methods: A total of 602 COVID-19 patients who were brought to the emergency department within the period from March to September 2020 were included in the study. The BUN level, albumin level, BAR, age, gender, and in-hospital mortality status of the patients were recorded. The patients were grouped by in-hospital mortality. Statistical comparison was conducted between the groups.

Results: Of the patients who were included in the study, 312(51.8%) were male, and their median age was 63 years (49-73). There was in-hospital mortality in 96(15.9%) patients. The median BUN and BAR values of the patients in the non-survivor group were significantly higher than those in the survivor group (BUN: 24.76 [17.38-38.31] and 14.43 [10.84-20.42], respectively [p < 0.001]; BAR: 6.7 [4.7-10.1] and 3.4 [2.5-5.2], respectively [p < 0.001]). The mean albumin value in the non-survivor group was significantly lower than that in the survivor group (3.60 ± 0.58 and 4.13 ± 0.51, respectively; p < 0.001). The area-under-the-curve (AUC) and odds ratio values obtained by BAR to predict in-hospital COVID-19 mortality were higher than the values obtained by BUN and albumin (AUC of BAR, BUN, and albumin: 0.809, 0.771, and 0.765, respectively; odds ratio of BAR>3.9, BUN>16.05, and albumin<4.01: 10.448, 7.048, and 6.482, respectively).

Conclusion: The BUN, albumin, and BAR levels were found to be reliable predictors of in-hospital mortality in COVID-19 patients, but BAR was found to be a more reliable predictor than the BUN and albumin levels.

Keywords: Blood Urea Nitrogen; COVID-19; In-hospital mortality; Serum Albumin.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
ROC curve by in-hospital mortality.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Inglesby T.V. Public health measures and the reproduction number of SARS-CoV-2. Jama. 2020;323(21):2186–2187. - PubMed
    1. Karamouzos V., Fligou F., Gogos C., Velissaris D. High flow nasal cannula oxygen therapy in adults with COVID-19 respiratory failure. A case report. Monaldi Arch Chest Dis. 2020;90(2) - PubMed
    1. Demir E.T., Kilic F. Determination of the anxiety level in pregnant women who administer to the obstetrics clinic within the COVID-19 pandemia period. Selcuk Med J. 2020;36(4):352–356.
    1. Martins-Filho P.R., de Souza Araújo A.A., Pereira L.X., Quintans-Júnior L.J., de Souza Barboza W., Cavalcante T.F., et al. Factors associated with mortality among hospitalized patients with COVID-19: a retrospective cohort study. Am J Trop Med Hyg. 2020;104(1):103–105. - PMC - PubMed
    1. Lanham D., Roe J., Chauhan A., Evans R., Hillman T., Logan S., et al. COVID-19 emergency department discharges: an outcome study. Clin Med. 2021;21(2):126–131. - PMC - PubMed

Publication types

MeSH terms