ArticleEuropean journal of medical research2025
J-shaped association between blood urea nitrogen-to-creatinine ratio and mortality in critically ill patients with acute pancreatitis: a retrospective cohort study using the MIMIC-IV database.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Multimodal AI for early prediction of adverse clinical outcomes in acute pancreatitis.Abdominal radiology (New York) · 2026Article
- Association between blood urea nitrogen-to-creatinine ratio trajectories and mortality in patients with severe pneumonia requiring invasive mechanical ventilation: a Medical Information Mart for Intensive Care IV (MIMIC-IV) database analysis.Journal of thoracic disease · 2026Article
- The correlation between blood urea nitrogen to creatinine ratio and short-term and long-term all-cause mortality in sepsis-associated acute kidney injury patients aged 50 and above: a large retrospective cohort study.Frontiers in endocrinology · 2026Article
- Association between blood urea nitrogen-to-creatinine ratio and mortality risk in critically ill patients with ventilator-associated pneumonia: a retrospective study.Frontiers in medicine · 2026Article
- Lactate dehydrogenase and short-term mortality in ICU patients with ischemic stroke: a single-center retrospective analysis of MIMIC-IV.European journal of medical research · 2025Article
- Development and validation of a nomogram for predicting 30-day mortality in patients with severe acute pancreatitis and pneumonia.Scientific reports · 2025Article
- Article
- BUN and mortality in patients with heparin-induced thrombocytopenia: A retrospective cohort study.Science progressArticle
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7 authors.
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Abstract
backgroundBoth blood urea nitrogen (BUN) and creatinine (Cr) are indicators of kidney function, and the BUN/Cr ratio has been identified as an independent prognostic marker for adverse outcomes in critically ill patients with various conditions. However, the relationship between the BUN/Cr ratio and long-term mortality in critically ill patients with acute pancreatitis (AP) remains unclear. Hence, the primary objective of this study was to determine the prognostic value of the BUN/Cr ratio in patients with AP.
methodsWe conducted a retrospective cohort study using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The primary exposure variable was the BUN/Cr ratio at intensive care unit (ICU) admission, and the primary outcome was 365-day all-cause mortality. Kaplan-Meier analyses and multivariate Cox proportional hazards models were used to assess this relationship, while restricted cubic spline (RCS) was used to explore potential non-linear associations. In addition, subgroup analyses were conducted to assess consistency between groups.
resultsA total of 850 critically ill patients with AP were included, with a mean age of 59.61 years, 58.59% male, and an overall 365-day mortality rate of 20.94%. Patients in the highest BUN/Cr quartile had significantly higher mortality rates compared to those in lower quartiles. Multivariate Cox regression analysis demonstrated that, even after adjusting for potential confounders, an elevated BUN/Cr ratio remained an independent predictor of increased 28-day and 365-day mortality. RCS analysis confirmed a J-shaped relationship between the BUN/Cr ratio and 28-day and 365-day mortality, with a sharp increase in the risk of death above the 16.80 threshold. Subgroup analysis indicated that this association was consistent across various patient characteristics.
conclusionThis study identified a non-linear relationship between the BUN/Cr ratio and 365-day mortality in critically ill patients with AP, suggesting that the BUN/Cr ratio may serve as an easily accessible, cost-effective, and accurate prognostic marker for this population.
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