2Department of Chest Diseases, Beytepe Murat Erdi Eker National Hospital, Ankara, Turkey
3Department of Chest Diseases, Gazi University Faculty of Medicine, Ankara, Turkey
4Department of Chest Diseases, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
5Department of Chest Diseases, Hitit University Faculty of Medicine, Çorum, Turkey
6Department of Chest Diseases, Ufuk University Faculty of Medicine, Ankara, Turkey
7Ufuk University Faculty of Medicine, Ankara, Turkey
8Department of Biostatistics, Ufuk University Doctor Rıdvan Ege Training and Research Hospital, Ankara, Turkey
Abstract
Objective: There is no definite laboratory parameter in predicting short-term prognosis in patients with chronic obstructive pulmonary disease (COPD). Our aim was to evaluate the prognostic effect of serum blood urea nitrogen (BUN)/albumin ratio in COPD patients.
Materials and Methods: A retrospective study comprising of 264 COPD patients who were in exacerbation period and selected from 4 centers was carried out. Data on demographic characteristics, disease characteristics, comorbid conditions and short-term prognosis of patients were obtained. and analyzed.
Results: The BUN/Albumin ratio was higher in patients with oxygen saturation <90% (p=0.004). There was no difference between global obstructive lung disease (GOLD) stages means of BUN/Albumin ratio but this rate was higher in those with infective exacerbations (p=0.019). The BUN/albumin ratio of patients who were discharged (5.3±2.2) was significantly higher than the patients who were transferred to the intensive care unit [ICU] (11.7±6.0) (p<0.0001). The cut-off level of BUN/albumin ratio in prediction of the need for ICU was7.2 (sensitivity 80%, specificity 85.4%) and the area under the receiver operating characteristic (ROC) curve was 0.911 (95% CI: 0.861–0.961) (p<0.001). The cut-off level of BUN/albumin ratio in prediction of mortality was 8.1 (sensitivity 88.2%, specificity 85.4%) and the area under the ROC curve was 0.963 (95% CI: 0.930–0.995) (p<0.001).
Conclusion: BUN/albumin ratio can be used as an affordable, inexpensive and practical method for determining the short-term prognosis in hospitalized COPD patients. Prospective studies involving more patients are needed.