ArticlePloS one2018
Blood Urea Nitrogen (BUN) is independently associated with mortality in critically ill patients admitted to ICU.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03930160 (Logistic Organ Dysfunction System Role in Predicting 30-day Mortality Outcome in Intensive Care Unit of dr. Cipto Mangunkusumo General Hospital Patients), which is not on this map. Cited by 79 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Logistic Organ Dysfunction System Role in Predicting 30-day Mortality Outcome in Intensive Care Unit of dr. Cipto Mangunkusumo General Hospital Patients
Who cites it
79 citing papers in PubMed, 3 syntheses or guidelines pooled it, 149 citations in OpenAlex.
- Biomarkers associated with post-operative pneumonia: a systematic review and meta-analysis.BMC pulmonary medicine · 2026Pooled it
- A pooled analysis of the risk prediction models for mortality in acute exacerbation of chronic obstructive pulmonary disease.The clinical respiratory journal · 2023Pooled it
- The Use of Glycomacropeptide in Patients with Phenylketonuria: A Systematic Review and Meta-Analysis.Nutrients · 2018Pooled it
- Acute intermittent hemodialysis management: a single center experience.Renal failure · 2026Article
- Article
- Hourly Blood Urea Nitrogen Trajectories and ICU Mortality Risk in Critically Ill Patients with Gastrointestinal Bleeding: A Multicenter Retrospective Cohort Study.Advances in therapy · 2026Article
- Optimal Dynamic Treatment Regimes for High-Dimensional Accelerated Failure Time Model.Statistics in medicine · 2026Article
- Predictors of cognitive resilience in the old-old: An observational study using real-world electronic health record data.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Observational
- Renal function dynamics in COVID-19: exploring biomarker interactions with D-dimer and C-reactive proteins.Bioscience reports · 2026Article
- Dynamic BUN patterns in the ICU: risk stratification and prognosis following cardiac surgery.Journal of cardiothoracic surgery · 2026Article
- The effect of blood urea nitrogen (BUN)/albumin ratio in evaluating mortality in pediatric burn patients with 20% or greater total body surface area involvement.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Multidrug resistant tuberculosis (MDR-TB) in Eritrea: a retrospective cohort analysis of mortality and associated factors (2013 - 2023).Frontiers in cellular and infection microbiology · 2026Article
- Blood urea nitrogen to albumin ratio and mortality in critically ill patients with cardiogenic shock.PloS one · 2026Article
- Increased blood urea nitrogen to serum albumin ratio is associated with poor prognosis in patients with acute pancreatitis: a retrospective cohort study.Archives of medical science : AMS · 2026Article
- Association between admission blood urea nitrogen and clinical outcomes in patients with large ischemic stroke undergoing endovascular treatment.Frontiers in neurology · 2026Article
- Interpretable machine learning based on the Charlson comorbidity index predicts 28-day mortality in acute hypercapnic respiratory failure.Scientific reports · 2025Article
- Association between blood urea nitrogen levels and mortality in critical acute ischemic stroke patients.Scientific reports · 2025Article
- Knockoff-ML: a knockoff machine learning framework for controlled variable selection and risk stratification in electronic health record data.NPJ digital medicine · 2025Article
- The association between blood urea nitrogen to albumin ratio and 28-day ICU mortality in sepsis patients: a retrospective cohort study.European journal of medical research · 2025Article
- Exposure to pesticides and renal function in agricultural workers in Rafsanjan, Iran: a case-control study.Journal of health, population, and nutrition · 2025Article
19 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeBlood urea nitrogen (BUN) was reported to be associated with mortality in heart failure patients. We aimed to evaluate admission BUN concentration in a heterogeneous critically ill patient collective admitted to an intensive care unit (ICU) for prognostic relevance.
methodsA total of 4176 medical patients (67±13 years) admitted to a German ICU between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. Association of admission BUN and both intra-hospital and long-term mortality were investigated by Cox regression. An optimal cut-off was calculated by means of the Youden-Index.
resultsPatients with higher admission BUN concentration were older, clinically sicker and had more pronounced laboratory signs of multi-organ failure including kidney failure. Admission BUN was associated with adverse long-term mortality (HR 1.013; 95%CI 1.012-1.014; p<0.001). An optimal cut-off was calculated at 28 mg/dL which was associated with adverse outcome even after correction for APACHE2 (HR 1.89; 95%CI 1.59-2.26; p<0.001), SAPS2 (HR 1.85; 95%CI 1.55-2.21; p<0.001) and several parameters including creatinine in an integrative model (HR 3.34; 95%CI 2.89-3.86; p<0.001). We matched 614 patients with admission BUN >28 mg/dL to case-controls ≤ 28mg/dL corrected for APACHE2 scores: BUN above 28 mg/dL remained associated with adverse outcome in a paired analysis with the difference being 5.85% (95%CI 1.23-10.47%; p = 0.02).
conclusionsHigh BUN concentration at admission was robustly associated with adverse outcome in critically ill patients admitted to an ICU, even after correction for co-founders including renal failure. BUN might constitute an independent, easily available and important parameter for risk stratification in the critically ill.
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