Objective To explore the correlation between blood urea nitrogen(BUN)to albumin(ALB)ratio(BAR)and prognosis of patients with cardiogenic shock(CS)combined with acute kidney injury(AKI).Methods A retrospective analysis was conducted on clinical data of 713 CS and AKI patients admitted to the intensive care unit(ICU)extracted from the US Medical Information Mart of Intensive Care IV v2.0 between 2008 and 2019.According to BAR quartiles at ICU admission,patients were divided into four groups:＜0.215 group(n=178),0.215～＜0.322 group(n=178),0.322～＜0.519 group(n=178),and ≥0.519(n=179)group.Based on the 90-day outcome,the patients were divided into survival group(n=364)and death group(n=349).The 90-day cumulative survival rates were compared among different BAR groups.The clinical data between the survivors and non-survivors were analyzed.Cox proportional hazards regression model was used to analyze risk factors for all-cause mortality within 90 days.Results There was a significant difference in 90-day cumulative survival rate among patients in different BAR groups(P＜0.001).Age,Acute Physiology And Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,BUN,BAR,white blood cell count,alkaline phosphatase,creatinine,blood phosphorus,lactate,the proportions of malignant tumors and cardiac arrest,the use of norepinephrine,vasopressin and renal replacement therapy were significantly higher in death group than in survival group(all P＜0.05),while ALB,red blood cell count,platelet count,bicarbonate level,and the proportions of congestive heart failure and coronary artery bypass grafting,the use of temporary cardiac pacing and intra-aortic balloon counterpulsation were significantly lower compared to the survival group(all P＜0.05).BAR ≥0.519 was an independent risk factor for 90-day all-cause mortality(HR=1.646,P=0.013).Conclusion BAR ≥0.519 at ICU admission indicates poor short-term prognosis in patients with CS combined with AKI.
Urea nitrogen to albumin ratioCardiogenic shockAcute kidney injuryPrognosis
万方数据
维普
