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 language | English (US) |
|---|---|
| Pages (from-to) | 305-313 |
| Number of pages | 9 |
| Journal | Critical Care Medicine |
| Volume | 39 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2011 |
| Externally published | Yes |
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Keywords
- blood urea nitrogen
- creatinine
- gastrointestinal bleed
- intensive care
- mortality
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of normal creatinine
AU - Beier, Kevin
AU - Eppanapally, Sabitha
AU - Bazick, Heidi S.
AU - Chang, Domingo
AU - Mahadevappa, Karthik
AU - Gibbons, Fiona K.
AU - Christopher, Kenneth B.
PY - 2011/2
Y1 - 2011/2
N2 - 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;
AB - 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;
KW - blood urea nitrogen
KW - creatinine
KW - gastrointestinal bleed
KW - intensive care
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=79251577608&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79251577608&partnerID=8YFLogxK
U2 - 10.1097/CCM.0b013e3181ffe22a
DO - 10.1097/CCM.0b013e3181ffe22a
M3 - Article
C2 - 21099426
AN - SCOPUS:79251577608
VL - 39
SP - 305
EP - 313
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 2
ER -