A STUDY OF THE ROLE OF SERUM ALBUMIN LEVELS AND BLOOD UREA NITROGEN/ALBUMIN RATIO IN PREDICTING OF THE PROGNOSIS OF COMMUNITY ACQUIRED PNEUMONIA
Main Article Content
Keywords
Community-Acquired Pneumonia; BUN, Serum Albumin, BUN/Albumin Ratio, CURB-65, PSI.
Abstract
Community-acquired pneumonia (CAP) remains a significant cause of morbidity and mortality worldwide. Although commonly used scoring systems such as CURB-65 and the Pneumonia Severity Index (PSI) help assess disease severity, their predictive accuracy for mortality and the need for intensive care unit (ICU) admission is remains limited. Recent studies have indicated that low serum albumin levels are associated with poorer outcomes in CAP, while elevated blood urea nitrogen (BUN) levels and decreased albumin levels correlate with higher mortality. The present study aimed to evaluate the role of serum albumin levels and the BUN/Albumin (BUN/Alb) ratio in predicting disease severity, complications, ICU requirements, and one-month mortality in patients with CAP.
Materials
This study included 121 patients aged above 18 years who were diagnosed with community-acquired pneumonia. Laboratory investigations included complete blood counts, serum albumin levels, and BUN levels, from which the BUN/Alb ratio was calculated. The CURB-65 and PSI scores were also determined for each patient. Individuals with immunocompromised states, chronic liver disease, chronic renal failure, or those receiving immunosuppressive therapy were excluded from the study.
Results
A total of 121 patients were enrolled. Patients requiring ICU admission demonstrated significantly higher BUN/Alb ratios (p<0.001) and higher mortality rates (p<0.001). Thirteen patients required ICU care. These patients had higher CURB-65 (≥2) and PSI (≥3) scores and lower serum albumin levels. Low serum albumin was a significant risk factor for ICU admission (p<0.001). Mean BUN levels were higher among ICU patients (23.76 ± 5.54, p<0.001), as was the BUN/Alb ratio (mean 7.1, p<0.001). The optimal BUN/Alb ratio cut-off for predicting ICU admission was 5.78, with a sensitivity of 89.1% and a specificity of 67.7%.
Conclusion
Patients with CAP who exhibit higher BUN/Albumin ratios are at greater risk of requiring ICU admission. Low serum albumin levels are significant predictors of disease severity and the need for ICU admissions in pneumonia.
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Dr. Basavaraj Bannigidad
Senior Resident, Department of General Medicine, Karnataka Medical College and Research Institute (KMCRI), Hubli, Karnataka, India.
Dr. Vishal Somashekhar Nulvi
Junior Resident, Department of General Medicine, Karnataka Medical College and Research Institute (KMCRI), Hubli, Karnataka, India.
Dr. Seetaram N.K.
Associate Professor, Department of General Medicine, Karnataka Medical College and Research Institute (KMCRI), Hubli, Karnataka, India.
Dr. Gayathri B.H.
Associate Professor, Department of General Medicine, Karnataka Medical College and Research Institute (KMCRI), Hubli, Karnataka, India.
Dr. Amit V. Khatawkar
Associate Professor, Department of General Medicine, Karnataka Medical College and Research Institute (KMCRI), Hubli, Karnataka, India.