ArticleInternational journal of chronic obstructive pulmonary disease2023
Elevated BUN Upon Admission as a Predictor of in-Hospital Mortality Among Patients with Acute Exacerbation of COPD: A Secondary Analysis of Multicenter Cohort Study.
Article in International journal of chronic obstructive pulmonary disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Association between COPD and CKD: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Correlation between urea-to-creatinine ratio and poor prognosis of intensive care unit patients with chronic obstructive pulmonary disease: a study based on the MIMIC-IV database.BMC pulmonary medicine · 2026Article
- Association between blood urea nitrogen trajectory phenotypes and prognosis in patients with sepsis: a multicenter retrospective cohort study.BMC infectious diseases · 2026Observational
- Predictive Value of SAPS II for 28-Day All-Cause Mortality in AECOPD Patients Admitted to the ICU.International journal of chronic obstructive pulmonary disease · 2026Article
- Development and Internal Validation of a Multivariable Prognostic Model for in-Hospital Mortality in Critically Ill Patients with Acute Exacerbation of COPD.International journal of chronic obstructive pulmonary disease · 2026Observational
- Low levels of serum albumin and blood basophils as 10-year mortality predictors in a nationwide Korean COPD cohort.Scientific reports · 2025Article
- Survival prediction model for hypoxemic patients receiving post-extubation oxygen therapy after invasive ventilation: based on the MIMIC database.Journal of thoracic disease · 2025Article
- Association between blood urea nitrogen-to-albumin ratio and mortality in ICU patients with chronic obstructive pulmonary disease: data from the MIMIC IV database.BMC geriatrics · 2025Article
- Predictive value of combined detection of blood Urea nitrogen and Neutrophil-to-lymphocyte ratio for identifying severe pneumonia complicated with sepsis in neonates.BMC infectious diseases · 2025Article
- Association between blood urea nitrogen to albumin ratio and 28-day mortality in ICU patients with acute respiratory failure: a retrospective analysis of MIMIC-IV database.BMC medical informatics and decision making · 2025Article
- Associations of the triglyceride-glucose index with mortality mediated by blood urea nitrogen among critically ill patients: a cohort study.Scientific reports · 2025Article
- Hemoglobin and clinical outcomes of in-hospital patients with severe acute exacerbation of chronic obstructive pulmonary disease: a multicenter cohort study.Frontiers in medicine · 2025Article
- Article
- Validation of the Rome Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbation: A Multicenter Cohort Study.International journal of chronic obstructive pulmonary disease · 2024Article
- The Relationship Between Blood Urea Nitrogen to Creatinine Ratio and Severe Acute Exacerbation of COPD Patients: A Propensity Score Matching Study.International journal of chronic obstructive pulmonary disease · 2024Article
- Development and Validation of an In-Hospital Mortality Prediction Model for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2024Article
- Risk factors of in-hospital mortality and discriminating capacity of NIVO score in exacerbations of COPD requiring noninvasive ventilation.Chronic respiratory diseaseArticle
- Machine learning-based prediction of in-hospital mortality in patients with chronic respiratory disease exacerbations.Digital healthArticle
- Patients' outcomes during chronic obstructive pulmonary disease exacerbations are associated with the severity score of the Lancet Commission.Annals of thoracic medicineArticle
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Authors and funding
19 authors at 11 institutions in 1 country.
Funding
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Abstract
Background: High blood urea nitrogen (BUN) is observed in a subset of patients with acute exacerbation of COPD (AECOPD) and may be linked to clinical outcome, but findings from previous studies have been inconsistent. Methods: We performed a retrospective analysis of patients prospectively enrolled in the MAGNET AECOPD Registry study (ChiCTR2100044625). Receiver operating characteristic (ROC) was used to determine the level of BUN that discriminated survivors and non-survivors. Univariate and multivariate Cox proportional hazards regression analyses were performed to assess the impact of BUN on adverse outcomes. Results: Overall, 13,431 consecutive inpatients with AECOPD were included in this study, of whom 173 died, with the mortality of 1.29%. The non-survivors had higher levels of BUN compared with the survivors [9.5 (6.8-15.3) vs 5.6 (4.3-7.5) mmol/L, P < 0.001]. ROC curve analysis showed that the optimal cutoff of BUN level was 7.30 mmol/L for in-hospital mortality (AUC: 0.782; 95% CI: 0.748-0.816; P < 0.001). After multivariate analysis, BUN level ≥7.3 mmol/L was an independent risk factor for in-hospital mortality (HR = 2.099; 95% CI: 1.378-3.197, P = 0.001), also for invasive mechanical ventilation (HR = 1.540; 95% CI: 1.199-1.977, P = 0.001) and intensive care unit admission (HR = 1.344; 95% CI: 1.117-1.617, P = 0.002). Other independent prognostic factors for in-hospital mortality including age, renal dysfunction, heart failure, diastolic blood pressure, pulse rate, PaCO2 and D-dimer. Conclusion: BUN is an independent risk factor for in-hospital mortality in inpatients with AECOPD and may be used to identify serious (or severe) patients and guide the management of AECOPD. Clinical Trial Registration: MAGNET AECOPD; Chinese Clinical Trail Registry NO.: ChiCTR2100044625; Registered March 2021, URL: http://www.chictr.org.cn/showproj.aspx?proj=121626.
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