Blood urea nitrogen to serum albumin ratio predicts 28-day and 90-day mortality in patients with acute pancreatitis: A retrospective cohort study

by Xu Cai, Xiaoqing Jiang, Wenbin Nan, Zhenyu Peng, Chenlu Wu, Kui Tang

Acute pancreatitis is a prevalent and severe digestive disease with significant mortality. Early identification of high-risk patients is essential for improving outcomes. The ratio of blood urea nitrogen to albumin (BAR) has emerged as a potential prognostic predictor in various critical illnesses. This study explores the associations between BAR and 28-day and 90-day mortality in acute pancreatitis patients.

This retrospective cohort study enrolled patients diagnosed with acute pancreatitis from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. BAR was calculated using initial blood urea nitrogen and serum albumin. Patients were categorized into three groups according to the tertiles (T1-T3) of BAR values. Kaplan-Meier survival analysis and restricted cubic spline (RCS) curve assessed the impact of BAR on overall survival. Multivariate Cox regression analysis was used to determine association of BAR with 28-day and 90-day mortality in acute pancreatitis. The receiver operating characteristic (ROC) curve was employed to assess the predictive value of BAR for 28-day and 90-day mortality in acute pancreatitis.

In this study, 452 patients with acute pancreatitis were analyzed, with 28-day mortality rate of 11.7% and 90-day mortality rate of 13.7%. Kaplan-Meier survival analysis indicated a notable increase in mortality rates at 28 days and 90 days among patients with elevated BAR levels (Log-rank P  Conclusion

Higher BAR values were significantly associated with increased 28-day and 90-day mortality in acute pancreatitis patients. Moreover, BAR may serve as a simple and effective tool for identifying higher death risk of patients with acute pancreatitis.