Why the study?
The blood urea nitrogen to serum albumin ratio has prognostic value in critical illness, but its role in decompensated heart failure with reduced ejection fraction is understudied.
Does an elevated BUN-to-albumin ratio (BAR) on admission predict increased length of stay, in-hospital mortality, and 30-day readmissions in patients hospitalized with decompensated HFrEF?
Does an elevated BUN-to-albumin ratio (BAR) on admission predict increased length of stay, in-hospital mortality, and 30-day readmissions in patients hospitalized with decompensated HFrEF?
An elevated admission BUN-to-albumin ratio (BAR) serves as an accessible, cost-effective biomarker strongly associated with increased in-hospital mortality and prolonged length of stay in patients with decompensated HFrEF.
Background: Decompensated heart failure with reduced ejection fraction (D-HFrEF) is a prevalent cause of hospitalization and mortality. Early risk stratification is crucial for targeted interventions. The blood urea nitrogen to serum albumin ratio (BAR) has shown prognostic value in critical illness, but its role in D-HFrEF is understudied. Objectives: This study aimed to evaluate the association of BAR calculated within 24 h of admission with length of hospital stay (LOS), in-hospital mortality, and 30-day readmissions in patients hospitalized with D-HFrEF and identify an optimal cut-off value for each outcome. Methods and Receiver operating characteristic analysis identified optimal BAR cut-off points of 6.82 for mortality. Conclusions: Our data show that an elevated BAR on admission is associated with increased in-hospital mortality and LOS > 30 days in patients hospitalized for D-HFrEF. This readily available marker can aid in identifying patients at higher risk for adverse events. Prospective studies are needed to validate our findings.
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Abofrekha et al. (2025) studied this question.
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