Key result
Blood urea nitrogen levels ≥6.8 mmol/L upon admission independently predicted a higher risk of in-hospital mortality (aOR 2.365) in patients with infective endocarditis.
Why the study?
Blood urea nitrogen is an established independent prognostic factor in several diseases, but its prognostic value in patients with infective endocarditis remained unevaluated.
Does elevated blood urea nitrogen at admission predict short-term mortality in patients with infective endocarditis?
Cohort (n=1,371)
No
Does elevated blood urea nitrogen at admission predict short-term mortality in patients with infective endocarditis?
Elevated blood urea nitrogen (>6.8 mmol/L) at admission serves as an independent predictor of in-hospital and 6-month mortality in patients with infective endocarditis.
Answers are grounded in this paper and cite their sources.
May aid risk stratification in infective endocarditis; hypothesis-generating and requires prospective validation.
INTRODUCTION: Blood urea nitrogen (BUN) is a metabolic product validated to be an independent risk factor in the prognosis of several diseases. However, the prognostic value of BUN in patients with infective endocarditis (IE) remains unevaluated. METHODS: A total of 1371 patients with a diagnosis of IE were included and divided into four groups according to BUN (mmol/L) at admission: < 3.5 (n = 343), 3.5-4.8 (n = 343), 4.8-6.8 (n = 341), and ≥ 6.8 (n = 344). Restricted cubic spline was used to assess the association of BUN with in-hospital mortality. Multivariate analysis was performed to identify the independent risk factors for adverse outcomes. RESULTS: The in-hospital mortality reached 7.4%, while the 6-month mortality was 9.8%. The restricted cubic spline plot exhibited an approximately linear relationship between BUN and in-hospital mortality. Receiver operating characteristics curve analysis showed that the optimal cut-off of BUN for predicting in-hospital death was 6.8 mmol/L. Kaplan-Meier analysis showed that patients with BUN > 6.8 mmol/L had a higher 6-month mortality than other groups (log rank = 97.9, P < 0.001). Multivariate analysis indicated that BUN > 6.8 mmol/L was an independent predictor indicator for both in-hospital [adjusted odds ratio (aOR) = 2.365, 95% confidence interval (CI) 1.292-4.328, P = 0.005] and 6-month mortality [adjusted hazard ratio (aHR) = 2.171, 95% CI 1.355-3.479, P = 0.001]. CONCLUSIONS: BUN is suitable for independently predicting short-term mortality in patients with IE.
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Wang et al. (2023) conducted a cohort in Infective endocarditis (n=1,371). Blood urea nitrogen ≥ 6.8 mmol/L vs. Blood urea nitrogen < 6.8 mmol/L was evaluated on All-cause mortality during hospitalization (aOR 2.365, 95% CI 1.292-4.328, p=0.005). Blood urea nitrogen levels ≥6.8 mmol/L upon admission independently predicted a higher risk of in-hospital mortality (aOR 2.365) in patients with infective endocarditis.
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