Mustafa A Tatlisu1, Adnan Kaya2, Muhammed Keskin3, Sahin Avsar3, Mehmet Bozbay3, Kiymet Tatlisu4, Mehmet Eren3. 1. Department of Cardiovascular Science, Texas A&M Institute for Preclinical Science, College Station, TX, 77843, USA. Electronic address: ademtatlisu@gmail.com. 2. Department of Cardiology, Suruc State Hospital, Urfa, 63800, Turkey. 3. Department of Cardiology, Dr. Siyami Ersek Cardiovascular Surgery Research and Training Hospital, Istanbul, 34773, Turkey. 4. Department of Family Medicine, Yenidogan Public Health Center, Istanbul, 34791, Turkey.
Abstract
BACKGROUND: The aim of this study was to investigate the association of BUN levels with in-hospital and long-term adverse clinical outcomes in acute pulmonary embolism (APE) patients treated with tissue-plasminogen activator (t-PA). METHODS: This retrospective study included 252 consecutive confirmed APE patients treated with t-PA. An admission BUN of 34.5 mg/dL was identified through an ROC analysis as an optimal cutoff value to predict the in-hospital mortality with 85% sensitivity and 91% specificity (AUC: 0.91; 95% CI: 0.84-0.96; P<.001). RESULTS: Our study showed that an increase in BUN levels was independently associated with a high risk of in-hospital all-cause mortality, low admission systolic blood pressure, use of inotropic drugs, and cardiogenic shock. In-hospital mortality rates were 51.1% in higher BUN group, and 1.9% in lower BUN group (P<.001). CONCLUSION: In this study, elevated admission BUN level was found to be a predictor of all-cause in-hospital mortality. BUN testing is commonly part of the basic metabolic panel; and it can be used to detect high-risk patients with APE, and it bears little risk, is inexpensive, and easy to perform. Published by Elsevier Inc.
BACKGROUND: The aim of this study was to investigate the association of BUN levels with in-hospital and long-term adverse clinical outcomes in acute pulmonary embolism (APE) patients treated with tissue-plasminogen activator (t-PA). METHODS: This retrospective study included 252 consecutive confirmed APE patients treated with t-PA. An admission BUN of 34.5 mg/dL was identified through an ROC analysis as an optimal cutoff value to predict the in-hospital mortality with 85% sensitivity and 91% specificity (AUC: 0.91; 95% CI: 0.84-0.96; P<.001). RESULTS: Our study showed that an increase in BUN levels was independently associated with a high risk of in-hospital all-cause mortality, low admission systolic blood pressure, use of inotropic drugs, and cardiogenic shock. In-hospital mortality rates were 51.1% in higher BUN group, and 1.9% in lower BUN group (P<.001). CONCLUSION: In this study, elevated admission BUN level was found to be a predictor of all-cause in-hospital mortality. BUN testing is commonly part of the basic metabolic panel; and it can be used to detect high-risk patients with APE, and it bears little risk, is inexpensive, and easy to perform. Published by Elsevier Inc.
Authors: Okan Arihan; Bernhard Wernly; Michael Lichtenauer; Marcus Franz; Bjoern Kabisch; Johanna Muessig; Maryna Masyuk; Alexander Lauten; Paul Christian Schulze; Uta C Hoppe; Malte Kelm; Christian Jung Journal: PLoS One Date: 2018-01-25 Impact factor: 3.240