Kocaeli Med J. 2022; 11(3): 157-171 | DOI: 10.5505/ktd.2022.48742

Investigation of the Relationship between Blood Urea Nitrogen / Serum Albumin Ratio and Clinical Course in Patients with COVID-19 Pneumonia

Aksel Özdemir, Melih Yüksel, Mehmet Oguzhan Ay, Halil Kaya, Ümran Doðru, Mehtap Bulut
University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine, Bursa,Turkey

INTRODUCTION: This study aims to investigate whether the Blood Urea Nitrogen to Serum Albumin ratio (BAR) as well as the CURB-65, NEWS-2, and TREWS scores which are measured at admission are effective predictors of mortality and prognosis in patients with COVID-19 pneumonia.
METHODS: BAR, CURB-65, NEWS-2, and TREWS scores were calculated and a ROC curve was drawn to examine their diagnostic value in predicting 28-day mortality.
RESULTS: The BAR (p<0.001), CURB-65 (p<0.001), NEWS-2 (p<0.001), and TREWS (p<0.001) scores of the patients who died within the 28-day period were statistically significantly different. In the ROC analysis to predict 28-day mortality, the area under the curve (AUC) was found to be 0.875 for BAR [(95% CI 0.826-0.924), (p<0.001)], 0.887 for CURB-65 [(95% CI 0.834-0.940), (p<0.001)], 0.837 for NEWS-2 [(95% CI 0.768-0.907), (p<0.001)], and 0.852 for TREWS [(95% CI 0.787-0.918), (p<0.001)]. When the cut-off value of BAR in predicting 28-day mortality was taken as 4.440, the sensitivity was found to be 93.2%, specificity was 70.6%.
DISCUSSION AND CONCLUSION: The BAR, which is a simple, inexpensive and easily available parameter, is highly effective in predicting 28-day mortality in patients with COVID-19 pneumonia. It can also be used with other scoring systems.

Keywords: emergency department, COVID-19, pneumonia, BUN/albumin ratio, mortality

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COVID-19 Pnömonisi Olan Olgularda Kan Üre Azotu/Albümin Oranýnýn Klinik Seyirle Ýliþkisinin Ýncelenmesi

Aksel Özdemir, Melih Yüksel, Mehmet Oguzhan Ay, Halil Kaya, Ümran Doðru, Mehtap Bulut
Saðlýk Bilimleri Üniversitesi, Bursa Yüksek Ýhtisas Eðitim ve Araþtýrma Hastanesi, Acil Týp Kliniði, Bursa,Türkiye

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, acil servise baþvuran COVID-19 pnömonili hastalarda baþvuru esnasýnda ölçülen Kan Üre Azotu/Albümin oraný (BAR) ile CURB-65, NEWS-2 ve TREWS skorlarýnýn mortalite ve prognoz tahmininde etkili bir belirteç olup olmadýðýný araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Hastalarýn BAR, CURB-65, NEWS-2 ve TREWS skorlarý hesaplanarak 28 günlük mortalite açýsýndan tanýsal deðerlerinin araþtýrýlmasý için ROC eðrisi çizildi.
BULGULAR: Hastalarýn BAR, CURB-65, NEWS-2 ve TREWS skorlarý hesaplanarak 28 günlük mortalite açýsýndan tanýsal deðerlerinin araþtýrýlmasý için ROC eðrisi çizildi.
BULGULAR: Yirmi sekiz günlük sürede mortalite geliþen hastalarýn sýrasý ile BAR deðeri (p<0,001), CURB-65 (p<0,001), NEWS-2 (p<0,001), ve TREWS (p<0,001) skorlarýnýn, istatistiksel olarak anlamlý derecede farklý olduðu görüldü. BAR’ýn 28 günlük mortaliteyi öngörmede kullanýmý için yapýlan ROC analizinde; eðri altýndaki alan (AUC) deðeri 0,875 [(%95 GA 0,826-0,924), (p<0.001)], CURB-65 skorunun AUC deðeri 0,887 [(%95 GA 0,834-0,940), (p<0.001)], NEWS-2 skorunun AUC deðeri 0,837 [(%95 GA 0,768-0,907), (p<0.001)], TREWS skorunun AUC deðeri 0,852 [(%95 GA 0,787-0,918), (p<0.001)] olarak bulundu. BAR’ýn 28 günlük mortaliteyi öngörmede kesim deðeri 4,440 olduðunda sensitivitesi % 93,2, spesifitesi % 70,6 olarak saptandý.

TARTIÞMA ve SONUÇ: Basit, ucuz ve kolay elde edilebilen bir parametre olan BAO, COVÝD-19 pnömonisi olan hastalarda 28 günlük mortaliteyi öngörmede oldukça etkilidir. Ayný zamanda diðer skorlama sistemleri ile de beraber kullanýlabilir.

Anahtar Kelimeler: acil servis, COVÝD-19, pnömoni, kan üre azotu/albümin oraný, mortalite

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