Postoperative Blood Urea Nitrogen-to-Albumin Ratio Predicts 90-Day Mortality Following Burn Surgery
Abstract
INTRODUCTION
The blood urea nitrogen-to-albumin ratio (BAR) is an emerging prognostic marker that combines information about renal perfusion, protein metabolism, and nutritional and inflammatory status. BAR has potential as a simple and objective indicator of mortality risk in burn populations. This study evaluated whether the postoperative BAR is a useful prognostic marker of 90-d mortality following burn surgery.
METHODS
This retrospective study included adult burn intensive care unit patients who underwent surgery between 2013 and 2022. Postoperative BAR was calculated within 24 h of burn surgery. The primary outcome was postoperative 90-d mortality. Secondary outcomes were postoperative sepsis, pneumonia, and acute kidney injury. Multivariate Cox proportional hazards regression, receiver operating characteristic curve, Kaplan-Meier, propensity score matching, conditional logistic regression, and stratified Cox regression analyses were conducted.
RESULTS
Among 982 patients, the overall 90-d mortality rate was 26.5%. Multivariate Cox proportional hazards regression analysis identified postoperative BAR as an independent predictor of 90-d mortality. The area under the receiver operating characteristic curve for BAR predicting 90-d mortality was 0.818, with an optimal cutoff of 6.5. Kaplan-Meier analysis showed significantly lower survival in patients with BAR ≥ 6.5 (log-rank P < 0.001). After 1:1 propensity score matching, BAR ≥ 6.5 was significantly associated with…
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