Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of normal creatinine

Kevin Beier, Sabitha Eppanapally, Heidi S. Bazick, Domingo Chang, Karthik Mahadevappa, Fiona K. Gibbons, Kenneth B. Christopher

Research output: Contribution to journalArticle

Abstract

Objective: We hypothesized that elevated blood urea nitrogen can be associated with all-cause mortality independent of creatinine in a heterogeneous critically ill population. Design: Multicenter observational study of patients treated in medical and surgical intensive care units. Setting: Twenty intensive care units in two teaching hospitals in Boston, MA. Patients: A total of 26,288 patients, age 18 yrs, hospitalized between 1997 and 2007 with creatinine of 0.80-1.30 mg/dL. Interventions: None. Measurements: Blood urea nitrogen at intensive care unit admission was categorized as 10-20, 20-40, and >40 mg/dL. Logistic regression examined death at days 30, 90, and 365 after intensive care unit admission as well as in-hospital mortality. Adjusted odds ratios were estimated by multivariable logistic regression models. Main Results: Blood urea nitrogen at intensive care unit admission was predictive for short- and long-term mortality independent of creatinine. Thirty days following intensive care unit admission, patients with blood urea nitrogen of >40 mg/dL had an odds ratio for mortality of 5.12 (95% confidence interval, 4.30-6.09; p <.0001) relative to patients with blood urea nitrogen of 10-20 mg/dL. Blood urea nitrogen remained a significant predictor of mortality at 30 days after intensive care unit admission following multivariable adjustment for confounders; patients with blood urea nitrogen of >40 mg/dL had an odds ratio for mortality of 2.78 (95% confidence interval, 2.27-3.39; p <.0001) relative to patients with blood urea nitrogen of 10-20 mg/dL. Thirty days following intensive care unit admission, patients with blood urea nitrogen of 20-40 mg/dL had an odds ratio of 2.15 (95% confidence interval, 1.98-2.33;

Original languageEnglish (US)
Pages (from-to)305-313
Number of pages9
JournalCritical Care Medicine
Volume39
Issue number2
DOIs
StatePublished - Feb 2011
Externally publishedYes

Fingerprint

Blood Urea Nitrogen
Critical Illness
Intensive Care Units
Creatinine
Mortality
Odds Ratio
Logistic Models
Patient Admission
Confidence Intervals
Critical Care
Hospital Mortality
Teaching Hospitals
Multicenter Studies
Observational Studies
Population

Keywords

  • blood urea nitrogen
  • creatinine
  • gastrointestinal bleed
  • intensive care
  • mortality

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Beier, K., Eppanapally, S., Bazick, H. S., Chang, D., Mahadevappa, K., Gibbons, F. K., & Christopher, K. B. (2011). Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of normal creatinine. Critical Care Medicine, 39(2), 305-313. https://doi.org/10.1097/CCM.0b013e3181ffe22a

Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of normal creatinine. / Beier, Kevin; Eppanapally, Sabitha; Bazick, Heidi S.; Chang, Domingo; Mahadevappa, Karthik; Gibbons, Fiona K.; Christopher, Kenneth B.

In: Critical Care Medicine, Vol. 39, No. 2, 02.2011, p. 305-313.

Research output: Contribution to journalArticle

Beier, K, Eppanapally, S, Bazick, HS, Chang, D, Mahadevappa, K, Gibbons, FK & Christopher, KB 2011, 'Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of normal creatinine', Critical Care Medicine, vol. 39, no. 2, pp. 305-313. https://doi.org/10.1097/CCM.0b013e3181ffe22a
Beier, Kevin ; Eppanapally, Sabitha ; Bazick, Heidi S. ; Chang, Domingo ; Mahadevappa, Karthik ; Gibbons, Fiona K. ; Christopher, Kenneth B. / Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of normal creatinine. In: Critical Care Medicine. 2011 ; Vol. 39, No. 2. pp. 305-313.
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KW - mortality

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