Prognostic value of blood urea nitrogen-to-albumin ratio in critically ill lung cancer patients
Abstract
urpose: This study aimed to investigate factors influencing mortality in intensive care units (ICUs)-treated lung cancer patients, focusing on the prognostic value of the blood urea nitrogen-to-serum albumin ratio (BAR).
Materials and Methods: This retrospective study included lung cancer patients treated in the ICU between 2020 and 2024. Clinical and laboratory data were collected, including demographics, reasons for ICU admission, and scores from BAR, Acute Physiology and Chronic Health Evaluation II (APACHE-II), and Sepsis-related Organ Failure Assessment (SOFA). BAR levels at admission, 24 hours, and 72 hours were analyzed for their predictive value on 30-day mortality using ROC analysis.
Results: Among 110 patients, the 30-day mortality rate was 21.8%. Increasing BAR values over time were significantly associated with mortality. The 72-hour BAR had the highest predictive power (AUC=0.783), surpassing APACHE-II and SOFA scores. Cox regression identified elevated BAR and the need for invasive mechanical ventilation (IMV) as independent predictors of mortality.
Conclusion: BAR is a valuable prognostic biomarker in ICU-managed lung cancer patients. Its dynamic assessment enhances predictive accuracy and may support early clinical decision-making.
Keywords
Lung Cancer , BAR , Mortality , ICU
Kaynakça
- Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in globocan 2012. Int J Cancer. 2015;136:E359-8.
- Puxty K, Grant CH, McLoone P, Sloan B, Quasim T, Hulse K et al. Factors associated with intensive care admission in patients with lung cancer: a population-based observational study of 26, 731 patients. BMC Pulm Med. 2020;20:36.
- Hu B, Xu G, Jin X, Chen D, Qian X, Li W et al. Novel prognostic predictor for primary pulmonary hypertension: focus on blood urea nitrogen. Front Cardiovasc Med. 2021;8:724179.
- Yıldız M, Çelik D, Özdemir T, Doğanay GE, Doğanci M, Cırık MÖ et al. The importance of uric acid levels in geriatric patients with respiratory failure under noninvasive mechanical ventilation in the respiratory intensive care unit. BMC Pulm Med. 2025;25:143.
- Çelik D, Yildiz M, Çifci A. Serum osmolarity does not predict mortality in patients with respiratory failure. Medicine (Baltimore). 2022;101:e28840.
- Harazim M, Tan K, Nalos M, Matejovic M. Blood urea nitrogen-independent marker of mortality in sepsis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023;167:24-9.
- Giri M, He L, Hu T, Puri A, Zheng X, Dai H et al. Blood urea nitrogen is associated with in-hospital mortality in critically ill patients with acute exacerbation of chronic obstructive pulmonary disease: a propensity score matching analysis. J Clin Med. 2022;11:6709.
- Dumitriu Carcoana AO, Labib KM, Fiedler CR, Marek JC, Ladehoff LC, West WJ 3rd et al. A high preoperative blood urea nitrogen to serum albumin ratio does not predict worse outcomes following the robotic-assisted pulmonary lobectomy for lung cancer. Cureus. 2023;15:e50468.
- Yang N, Han X, Yu J, Shu W, Qiu F, Han J. Hemoglobin, albumin, lymphocyte, and platelet score and neutrophil-to-lymphocyte ratio are novel significant prognostic factors for patients with small-cell lung cancer undergoing chemotherapy. J Cancer Res Ther. 2020;16:1134-9.
- Fanali G, di Masi A, Trezza V, Marino M, Fasano M, Ascenzi P. Human serum albumin: from bench to bedside. Mol Aspects Med. 2012;33:209-90.
