Cargando…
Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure
Blood urea nitrogen (BUN) is a surrogate marker for neurohormonal activation, but the association between BUN and the post-discharge prognosis in elderly patients with acute decompensated heart failure (ADHF) is not well defined. We explored the association between BUN and post-discharge all-cause m...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131513/ https://www.ncbi.nlm.nih.gov/pubmed/30202087 http://dx.doi.org/10.1038/s41598-018-31059-4 |
_version_ | 1783354118779174912 |
---|---|
author | Ren, Xiaohong Qu, Wei Zhang, Lijuan Liu, Miao Gao, Xuling Gao, Yuting Cheng, Xiaodan Xu, Weiwei Liu, Youhong |
author_facet | Ren, Xiaohong Qu, Wei Zhang, Lijuan Liu, Miao Gao, Xuling Gao, Yuting Cheng, Xiaodan Xu, Weiwei Liu, Youhong |
author_sort | Ren, Xiaohong |
collection | PubMed |
description | Blood urea nitrogen (BUN) is a surrogate marker for neurohormonal activation, but the association between BUN and the post-discharge prognosis in elderly patients with acute decompensated heart failure (ADHF) is not well defined. We explored the association between BUN and post-discharge all-cause mortality in 652 elderly patients (73.9 ± 7.8 yr) with ADHF. All patients were followed for a mean duration of 32 months (12–69 months). BUN was analyzed both as a continuous variable and according to two categories: low BUN group (BUN < 15.35 mmol/L, N = 361) and high BUN group (BUN ≥ 15.35 mmol/L, N = 291). The risk of all-cause mortality increased by 1.6% per 1 mmol/L increase in BUN concentration when BUN was used as a continuous variable [hazard ratio (HR): 1.016, 95% confidence interval (CI): 1.006–1.026, p = 0.002]. BUN maintained an independent and significant positive correlation with all-cause mortality as a categorical variable (HR: 1.355, 95% CI: 1.023–1.794, p = 0.034 for the high BUN group). The BUN C-statistic for predicting all-cause mortality was 0.624 (95% CI: 0.585–0.661). The cut-off value for BUN was 15.35 mmol/L with sensitivity of 0.58 and specificity of 0.63. The prognostic performance of BUN was similar to brain natriuretic peptide (BNP) for predicting all-cause mortality (C-statistic: z = 0.044, p = 0.965). These results suggest that BUN is an independent predictor of post-discharge all-cause mortality in elderly patients with ADHF and its prognostic performance was similar to that of BNP. |
format | Online Article Text |
id | pubmed-6131513 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-61315132018-09-13 Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure Ren, Xiaohong Qu, Wei Zhang, Lijuan Liu, Miao Gao, Xuling Gao, Yuting Cheng, Xiaodan Xu, Weiwei Liu, Youhong Sci Rep Article Blood urea nitrogen (BUN) is a surrogate marker for neurohormonal activation, but the association between BUN and the post-discharge prognosis in elderly patients with acute decompensated heart failure (ADHF) is not well defined. We explored the association between BUN and post-discharge all-cause mortality in 652 elderly patients (73.9 ± 7.8 yr) with ADHF. All patients were followed for a mean duration of 32 months (12–69 months). BUN was analyzed both as a continuous variable and according to two categories: low BUN group (BUN < 15.35 mmol/L, N = 361) and high BUN group (BUN ≥ 15.35 mmol/L, N = 291). The risk of all-cause mortality increased by 1.6% per 1 mmol/L increase in BUN concentration when BUN was used as a continuous variable [hazard ratio (HR): 1.016, 95% confidence interval (CI): 1.006–1.026, p = 0.002]. BUN maintained an independent and significant positive correlation with all-cause mortality as a categorical variable (HR: 1.355, 95% CI: 1.023–1.794, p = 0.034 for the high BUN group). The BUN C-statistic for predicting all-cause mortality was 0.624 (95% CI: 0.585–0.661). The cut-off value for BUN was 15.35 mmol/L with sensitivity of 0.58 and specificity of 0.63. The prognostic performance of BUN was similar to brain natriuretic peptide (BNP) for predicting all-cause mortality (C-statistic: z = 0.044, p = 0.965). These results suggest that BUN is an independent predictor of post-discharge all-cause mortality in elderly patients with ADHF and its prognostic performance was similar to that of BNP. Nature Publishing Group UK 2018-09-10 /pmc/articles/PMC6131513/ /pubmed/30202087 http://dx.doi.org/10.1038/s41598-018-31059-4 Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Ren, Xiaohong Qu, Wei Zhang, Lijuan Liu, Miao Gao, Xuling Gao, Yuting Cheng, Xiaodan Xu, Weiwei Liu, Youhong Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure |
title | Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure |
title_full | Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure |
title_fullStr | Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure |
title_full_unstemmed | Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure |
title_short | Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure |
title_sort | role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131513/ https://www.ncbi.nlm.nih.gov/pubmed/30202087 http://dx.doi.org/10.1038/s41598-018-31059-4 |
work_keys_str_mv | AT renxiaohong roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT quwei roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT zhanglijuan roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT liumiao roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT gaoxuling roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT gaoyuting roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT chengxiaodan roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT xuweiwei roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure AT liuyouhong roleofbloodureanitrogeninpredictingthepostdischargeprognosisinelderlypatientswithacutedecompensatedheartfailure |