Predictive performance of blood urea nitrogen to serum albumin ratio in elderly patients with gastrointestinal bleeding

Introduction: Acute gastrointestinal (GI) bleeding is one of the most important and the common causes of patients visiting the emergency department. Dehydrated state leads to increased blood urea nitrogen (BUN) and decreased albumin level. Many scoring systems had been developed to predict outcomes for patients with GI bleeding. Among the many scoring systems, the AIMS65 score was a simple and accurate risk assessment scoring tool. Therefore, in this study, we evaluated the prognostic performance of the blood urea nitrogen to serum albumin ratio (B/A ratio) compared to the AIMS65 score tool in elderly patients with GI bleeding. Material and methods: This was a retrospective cohort study of patients with GI bleeding in our institution from February 2018 through May 2020. Baseline characteristic data were obtained. The data were compared with the prevalence of ICU admission and in-hospital mortality. The B/A ratio and the AIMS65 score as predictors of ICU admission and in-hospital mortality was evaluated using the area under the receiver operating characteristic (AUROC) curve. Results: In the 596 patients included in the study, of whom 188 (31.5%) were admitted to the ICU and 36 (6.0%) died during hospitalization. Multivariate logistic regression analysis revealed that the B/A ratio was significant predictors of ICU admission and in-hospital mortality. In addition, the B/A ratio was significant higher in ICU admission patients and non-survivors. The AUROC value of the B/A ratio was 0.682 and that of the AIM565 score was 0.699 for predicting ICU admission. For predicting in-hospital mortality, the AUROC value was 0.770 and 0.763, respectively. Conclusion: The B/A ratio is as simple and useful tool for predicting outcomes for old aged GI bleeding patients as the AIMS65 score. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

Acute gastrointestinal bleeding is a common reason for emergency department visits, with dehydrated patients showing increased BUN and decreased albumin levels. The B/A ratio is found to be a significant predictor of ICU admission and in-hospital mortality, similar to the AIMS65 score, for elderly patients with GI bleeding.