The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective study

AimsThe purpose of this study was to explore the relationship between blood urea nitrogen to serum albumin ratio and 28-day in-hospital mortality in patients with chronic heart failure complicated by sepsis admitted to the intensive care unit (ICU).MethodsThis retrospective study included 723 patien...

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Main Authors: Ali Ma, Chen Zhang, Ying Gong, Xueping Ma, Ning Yan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1491331/full
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author Ali Ma
Ali Ma
Chen Zhang
Chen Zhang
Ying Gong
Ying Gong
Xueping Ma
Xueping Ma
Ning Yan
Ning Yan
author_facet Ali Ma
Ali Ma
Chen Zhang
Chen Zhang
Ying Gong
Ying Gong
Xueping Ma
Xueping Ma
Ning Yan
Ning Yan
author_sort Ali Ma
collection DOAJ
description AimsThe purpose of this study was to explore the relationship between blood urea nitrogen to serum albumin ratio and 28-day in-hospital mortality in patients with chronic heart failure complicated by sepsis admitted to the intensive care unit (ICU).MethodsThis retrospective study included 723 patients with chronic heart failure complicated by sepsis from the eICU database. Smooth curve fitting assessed the association between BAR and mortality. Multivariable Cox regression analysis was conducted to calculate the adjusted hazard ratio (HR) and 95% confidence interval (CI). Kaplan–Meier curves compared survival rates across BAR tertiles. Subgroup analysis was stratified based on relevant covariates and a forest plot was drawn to verify the stability of the results.ResultsAmong 723 chronic heart failure patients with sepsis, the 28-day mortality rate was 20.33% (147/723). After adjusting for confounders, with BAR as a categorical variable, patients in the highest tertile of BAR had a significantly higher death risk than those in the lowest tertile [HR: 1.87, 95% CI (1.09,3.19), p: 0.023]. When BAR was a continuous variable, each unit increase in BAR raised in—hospital mortality by 2% [HR: 1.02, 95% CI (1.01, 1.04), p = 0.0038]. Stratified analysis showed no interaction, and E—value analysis indicated robustness to unmeasured confounding, highlighting the stable and significant relationship between BAR and 28—day mortality in these patients.ConclusionIn the context of critically ill patients with chronic heart failure complicated by sepsis, there exists a significant correlation between blood urea nitrogen to serum albumin ratio (BAR) and 28-day mortality. Specifically, higher BAR levels are associated with an elevated risk of 28-day mortality in these patients. However, these findings require further research for confirmation.
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spelling doaj-art-6ac676aef35d4f878f2b026ca873784a2025-08-20T02:02:13ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-03-011210.3389/fcvm.2025.14913311491331The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective studyAli Ma0Ali Ma1Chen Zhang2Chen Zhang3Ying Gong4Ying Gong5Xueping Ma6Xueping Ma7Ning Yan8Ning Yan9First Clinical College, Ningxia Medical University, Yinchuan, ChinaHeart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, ChinaFirst Clinical College, Ningxia Medical University, Yinchuan, ChinaHeart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, ChinaFirst Clinical College, Ningxia Medical University, Yinchuan, ChinaHeart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, ChinaHeart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, ChinaInstitute of MedicalSciences, General Hospital of Ningxia Medical University, Yinchuan, ChinaHeart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, ChinaInstitute of MedicalSciences, General Hospital of Ningxia Medical University, Yinchuan, ChinaAimsThe purpose of this study was to explore the relationship between blood urea nitrogen to serum albumin ratio and 28-day in-hospital mortality in patients with chronic heart failure complicated by sepsis admitted to the intensive care unit (ICU).MethodsThis retrospective study included 723 patients with chronic heart failure complicated by sepsis from the eICU database. Smooth curve fitting assessed the association between BAR and mortality. Multivariable Cox regression analysis was conducted to calculate the adjusted hazard ratio (HR) and 95% confidence interval (CI). Kaplan–Meier curves compared survival rates across BAR tertiles. Subgroup analysis was stratified based on relevant covariates and a forest plot was drawn to verify the stability of the results.ResultsAmong 723 chronic heart failure patients with sepsis, the 28-day mortality rate was 20.33% (147/723). After adjusting for confounders, with BAR as a categorical variable, patients in the highest tertile of BAR had a significantly higher death risk than those in the lowest tertile [HR: 1.87, 95% CI (1.09,3.19), p: 0.023]. When BAR was a continuous variable, each unit increase in BAR raised in—hospital mortality by 2% [HR: 1.02, 95% CI (1.01, 1.04), p = 0.0038]. Stratified analysis showed no interaction, and E—value analysis indicated robustness to unmeasured confounding, highlighting the stable and significant relationship between BAR and 28—day mortality in these patients.ConclusionIn the context of critically ill patients with chronic heart failure complicated by sepsis, there exists a significant correlation between blood urea nitrogen to serum albumin ratio (BAR) and 28-day mortality. Specifically, higher BAR levels are associated with an elevated risk of 28-day mortality in these patients. However, these findings require further research for confirmation.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1491331/fullblood urea nitrogen to serum albumin ratiocongestive heart failuresepsiseICUin-hospital mortality
spellingShingle Ali Ma
Ali Ma
Chen Zhang
Chen Zhang
Ying Gong
Ying Gong
Xueping Ma
Xueping Ma
Ning Yan
Ning Yan
The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective study
Frontiers in Cardiovascular Medicine
blood urea nitrogen to serum albumin ratio
congestive heart failure
sepsis
eICU
in-hospital mortality
title The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective study
title_full The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective study
title_fullStr The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective study
title_full_unstemmed The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective study
title_short The association between blood urea nitrogen to serum albumin ratio and 28 day in-hospital mortality in patients with chronic heart failure and sepsis: a pilot retrospective study
title_sort association between blood urea nitrogen to serum albumin ratio and 28 day in hospital mortality in patients with chronic heart failure and sepsis a pilot retrospective study
topic blood urea nitrogen to serum albumin ratio
congestive heart failure
sepsis
eICU
in-hospital mortality
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1491331/full
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