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APPLICATION OF BLOOD UREA NITROGEN IN PREDICTING IN-HOSPITAL MORTALITY IN ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
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Abstract
Objective: To assess the association between blood urea nitrogen (BUN) levels and in-hospital mortality, and to evaluate its prognostic value in patients admitted with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Subjects and methods: This retrospective cohort study was conducted at the Emergency Department of the University Medical Center, Ho Chi Minh City, from January 2022 to December 2024. All patients aged ≥18 years admitted for AECOPD were included. Logistic regression and propensity score matching were applied to evaluate the prognostic significance of BUN. Result: A total of 521 patients were analyzed, of whom 33 (6.3%) died during hospitalization. The risk of in-hospital mortality increased 1.4-fold for each 1 mmol/L increase in BUN (p < 0.001). The area under the receiver operating characteristic (ROC) curve for BUN was 0.87 (95% CI: 0.81–0.93). A cut-off BUN level of 8.83 mmol/L was identified, which predicted a 16-fold increased risk of mortality (p < 0.001) with 76% sensitivity and 85% specificity. Conclusion: BUN is an independent predictor of in-hospital mortality in patients with AECOPD. A cut-off value of 8.83 mmol/L may be clinically useful for risk stratification and guiding early intervention.
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Keywords
acute exacerbation of chronic obstructive pulmonary disease, blood urea nitrogen, prognosis
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