The Association Of Blood Urea Nitrogen To Creatinine Ratio And The Prognosis Of Critically Ill Patients With Cerebral Infarction: A Cohort Study

Abstract Background: To evaluate the association between blood urea nitrogen (BUN) to creatinine (Cr) (BUN/Cr) ratio with the in-hospital mortality of critically ill patients with cerebral infarction in intensive care unit (ICU). Methods: In this cohort study, the data of 3059 participants with cerebral infarction were collected from the Medical Information Mart for Intensive Care (MIMIC)-III and the MIMIC-IV database. After propensity score matching (PSM) on age and gender, 2085 people were involved in and divided into the alive group (n=1390) and the dead group (n=695). All subjects in the ICU were followed up until death or discharge. Multivariate logistic analyses were applied for identifying the confounders and the association between BUN/Cr and mortality of cerebral infraction. Results: The median follow-up time was 10.5 days. Among 2778 participants, 695 were dead at the end of follow-up. Univariate analysis revealed that BUN/Cr risk ratio (RR)=1.01, 95% confidence interval (CI): 1.01-1.02 might be associated with the in-hospital mortality of cerebral infraction patients. After adjusting respiratory failure, malignant cancer, anticoagulation, liver disease, white blood cell (WBC), red cell distribution width (RDW) percent, glucose, bicarbonate and temperature, BUN/Cr was associated with an increased risk of in-hospital mortality of cerebral infraction patients (RR=1.01, 95%CI: 1.01-1.02). Conclusion: This study evaluated the association between BUN/Cr and the in-hospital mortality of cerebral infarction patients in ICU and found BUN/Cr was associated with an increased risk of in-hospital mortality of patients with cerebral infarction in ICU especially in males, and those with respiratory failure, malignant cancer and without liver disease, as well as those receiving anticoagulation. The findings of our study reminded the clinicians to pay attention on the level of BUN/Cr in cerebral infarction patients in ICU.