Blood urea nitrogen to creatinine ratio is associated with in-hospital mortality among critically ill patients with cardiogenic shock

BACKGROUNDS: Although Blood urea nitrogen (BUN) and serum creatinine concentration (Cr) has been widely measured in daily clinical practice, BUN-to-Cr ratio (BCR) for prognosis among patients admitted with cardiogenic shock (CS) remains unknown. The present study was conducted to assess the prognostic effectiveness of BCR on CS. METHODS AND RESULTS: Records of data for patients with CS were extracted from public database of the Medical Information Mart for Intensive Care-III (MIMIC-III). The primarily endpoint was in-hospital mortality. We incorporated multivariate Cox regression model and Kaplan–Meier curve to evaluate the relationship between BCR and in-hospital mortality, adjusting for potential confounders. Data of 1137 patients with CS were employed for the final cohort, with 556 in the low BCR (< 20) and 581 in the high BCR (≥ 20) group. In the multivariate Cox model and Kaplan–Meier curve, compared to low BCR, we found high BCR was independently associated with significantly improved in-hospital survival for CS (HR 0.66, 95% CI 0.51–0.84; P < 0.01). The benefit of high BCR on in-hospital survival for CS was remaining among subgroups of acute kidney injury (AKI) and non-AKI. CONCLUSIONS: Our analysis indicated that high BCR, as compared to low BCR, was correlated with improved in-hospital survival for participants with CS, with or without AKI. The results need to be proved in large prospective studies.