Higher urea-to-albumin ratio is associated with mortality risk in critically ill COVID-19 patients.

Autor: Rodrigues HCN; Faculty of Nutrition, University Federal of Goiás-UFG, Goiânia, Brazil. Electronic address: hellenchrisnutri@hotmail.com., Silva ML; Clinical Hospital, University Federal of Goiás-UFG, Goiânia, Brazil., Mantovani MDS; Clinical Hospital of Botucatu Medical School, São Paulo State University- UNESP, Botucatu, Brazil., Silva JMD; Clinical Hospital of Botucatu Medical School, São Paulo State University- UNESP, Botucatu, Brazil., Domingues MFP; Regional Hospital Costa Magid Thomé, Três Lagoas, Brazil., Tanni SÉ; Department of Internal Medicine, Botucatu Medical School, São Paulo State University- UNESP, Botucatu, Brazil., Azevedo PS; Department of Internal Medicine, Botucatu Medical School, São Paulo State University- UNESP, Botucatu, Brazil., Minicucci MF; Department of Internal Medicine, Botucatu Medical School, São Paulo State University- UNESP, Botucatu, Brazil., Buffarah MNB; Clinical Hospital of Botucatu Medical School, São Paulo State University- UNESP, Botucatu, Brazil., Pereira AG; Faculty of Medicine, University of São Paulo - USP, São Paulo, Brazil., Costa NA; Faculty of Nutrition, University Federal of Goiás-UFG, Goiânia, Brazil.
Jazyk: angličtina
Zdroj: Clinical nutrition ESPEN [Clin Nutr ESPEN] 2023 Aug; Vol. 56, pp. 9-12. Date of Electronic Publication: 2023 Apr 25.
DOI: 10.1016/j.clnesp.2023.04.017
Abstrakt: Background: This study aimed to evaluate the ability of the urea-to-albumin ratio (UAR) to predict mortality in critically ill coronavirus disease 2019 (COVID-19) patients.
Methods: This retrospective study included adult patients admitted with COVID-19 at two intensive care units (ICUs) at the University Hospital. Serum urea and albumin concentrations at ICU admission were used to calculate the UAR. All patients were followed up during hospitalization, and the ICU mortality rate was recorded.
Results: Two hundred and eleven patients were evaluated. The mean age was 57.8 ± 15.5 years, and 54% were male. Approximately 84.4% of patients were considered to be at nutritional risk by the NRS 2002, and the median UAR was 18.3 (10.5-34.8). The length of stay in the ICU was 10 (6-16) days, 38.4% of the patients required dialysis, and 64.9% died. Age, male sex, need of hemodialysis, lactate level, and inflammatory parameters were associated with higher mortality. Patients non-survivors had a higher UAR (23.7 [13.6-41.8] vs. 10.9 [8.5-16.8]; p < 0.001). The cutoff point with the best performance of UAR in the ROC curve for predicting mortality was ≥12.17 (AUC: 0.7201; CI 95%: 0.656-0.784). Additionally, the risk of mortality was 2.00-fold in the group of patients with UAR ≥12.17 (HR: 2.00 CI: 1.274-3.149; p = 0.003) and remained significant after adjusted analyzes (models 1 and 2).
Conclusion: Our data suggest that a UAR ≥12.17 increased the risk of mortality by 2.00-fold in critically ill COVID-19 patients.
Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest.
(Copyright © 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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