Title: The Role of Blood Urea Nitrogen / Albumin Ratio and Albumin Level in Predicting the Need for ICU Care (Intensive Respiratory and Vasopressor Support) in Community Acquired Pneumonia Patients
Authors: Dr Preethi. R. Gandhi, Dr Arvind.M.N, Dr Anila.Jose, Dr Tharuni Latha.A, Dr Hilas, Dr Rachitha.S
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.123
Abstract
Background: Community acquired pneumonia is an important cause of morbidity and mortality worldwide. CURB – 65 and PSI are the most frequently used scoring scales to assess disease severity. However their role regarding predicting mortality and need for ICU is low. Some studies have shown that patients with low serum albumin levels had poor outcome in CAP and those who had higher levels of BUN and lower albumin levels had higher mortality rates The aim of the study was to evaluate the role of albumin and BUN/Albumin ratio in the prediction for need of ICU (Intensive Respiratory and Vasopressor Support) and to derive a BUN/Alb ratio cut off score in predicting the need for IRVS .
Aims and Objectives: To assess the role of albumin and BUN/Albumin ratio in the prediction of need for ICU in adults patients >18 years of age admitted for CAP.
To derive a cut off value for BUN/Albumin ratio in predicting the need for IRVS.
Materials: In this study we have taken 50 patients who were of age above 18 yrs diagnosed to have Community Acquired Pneumonia. Complete blood count, serum albumin, BUN was measured and BUN/Alb ratio was calculated.Patients with immunocompromised states, chronic liver or renal failure and patients on immunosuppressive therapy were excluded.
Results: 50 patients diagnosed as CAP were included in the study. In this study the requirement of ICU care was indirectly taken by the need for intensive respiratory i.e. invasive ventilation and vasopressor support. 32% of the patients required IRVS.
In the IRVS group of patients (16 patients) the mean BUN, albumin and BUN/albumin ratio values were 15.08mg/dl, 3.26 g/dl and 4.73mg/dl respectively
In the non IRVS group (32 patients) then mean BUN, albumin and BUN/albumin ratio values were 14.86mg/dl, 3.54g/dl and 4.44 mg/dl respectively .
Thus it is found that in the two groups bun and bun/alb ratio was higher in the IRVS group and albumin lower in the IRVS group.
Conclusion: In our study, we found that patients who required IRVS had a higher BUN and BUN/albumin values and further had a lower Albumin values.
4.05 was the cut off scored derived from our study and a value equal to or above that predicts the need for IRVS with sensitivity of 62.5% and specificity of 62.8%.
Keywords: Community Acquired Pneumonia: Intensive Respiratory and Vasopressor Support; Blood Urea Nitrogen; Albumin.
