Research Article
Prognostic Value of Blood Urea Nitrogen/Creatinine Ratio for Septic Shock: An Analysis of the MIMIC-III Clinical Database
Table 3
Subgroup analysis of the associations between the BCR and 28-day all-cause mortality.
| | Characteristics | No. of patients | BCR | for interaction | | <14.4 | ≥14.4, <20.0 | ≥20.0, <27.3 | ≥27.3 | | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) |
| | Age (year) | | | | | | 0.104 | | <69 | 1228 | 1.0 (ref) | 0.824 (0.590-1.152) | 0.930 (0.652-1.326) | 1.165 (0.709-1.914) | | | ≥69 | 1256 | 1.0 (ref) | 1.130 (0.828-1.544) | 0.900 (0.656-1.236) | 1.275 (0.858-1.896) | | | Gender | | | | | | 0.867 | | Male | 1336 | 1.0 (ref) | 0.831 (0.616-1.121) | 0.853 (0.630-1.156) | 0.936 (0.611-1.433) | | | Female | 1148 | 1.0 (ref) | 1.033 (0.733-1.454) | 0.849 (0.591-1.220) | 1.206 (0.770-1.889) | | | Ethnicity | | | | | | 0.666 | | White | 1857 | 1.0 (ref) | 0.974 (0.753-1.261) | 0.886 (0.679-1.155) | 0.886 (0.679-1.155) | | | Black | 262 | 1.0 (ref) | 0.843 (0.341-2.041) | 0.482 (0.191-1.214) | 0.846 (0.236-3.037) | | | Other | 365 | 1.0 (ref) | 0.695 (0.381-1.266) | 0.945 (0.498-1.791) | 0.631 (0.249-1.600) | | | Marital status | | | | | | 0.980 | | Married | 1774 | 1.0 (ref) | 0.907 (0.700-1.175) | 0.846 (0.629-1.102) | 1.144 (0.810-1.616) | | | Unmarried | 690 | 1.0 (ref) | 0.907 (0.566-1.454) | 0.866 (0.527-1.423) | 1.160 (0.594-2.264) | | | Other | 20 | 1.0 (ref) | — | — | — | | | RRT | | | | | | 0.065 | | Yes | 231 | 1.0 (ref) | 0.829 (0.398-1.726) | 0.585 (0.130-2.263) | 0.714 (0.147-3.465) | | | No | 2253 | 1.0 (ref) | 1.050 (0.822-1.341) | 0.982 (0.769-1.255) | 1.255 (0.913-1.724) | | | Mech. vent | | | | | | 0.484 | | Yes | 1419 | 1.0 (ref) | 0.884 (0.684-1.143) | 0.812 (0.620-1.064) | 0.812 (0.620-1.064) | | | No | 1065 | 1.0 (ref) | 1.817 (1.111-2.973) | 1.732 (1.054-2.847) | 3.467 (1.833-6.558) | | | SOFA | | | | | | 0.955 | | <5 | 746 | 1.0 (ref) | 1.053 (0.578-1.919) | 0.910 (0.505-1.640) | 1.240 (0.599-2.564) | | | ≥5 | 1738 | 1.0 (ref) | 0.946 (0.743-1.204) | 0.881 (0.685-1.134) | 1.155 (0.818-1.632) | | | Elixhauser score | | | | | | 0.450 | | <13 | 1154 | 1.0 (ref) | 0.665 (0.458-0.964) | 0.623 (0.422-0.921) | 0.916 (0.537-1.561) | | | ≥13 | 1330 | 1.0 (ref) | 1.150 (0.871-1.518) | 1.066 (0.800-1.420) | 1.406 (0.963-2.051) | | | PT (second) | | | | | | 0.007 | | <14.9 | 1213 | 1.0 (ref) | 0.909 (0.604-1.366) | 0.943 (0.637-1.397) | 1.619 (0.995-2.635) | | | ≥14.9 | 1271 | 1.0 (ref) | 0.992 (0.759-1.298) | 0.826 (0.642-1.157) | 0.964 (0.637-1.460) | | | PTT (second) | | | | | | 0.535 | | <32 | 1240 | 1.0 (ref) | 1.073 (0.742-1.550) | 0.965 (0.669-1.391) | 1.374 (0.866-2.178) | | | ≥32 | 1244 | 1.0 (ref) | 0.883 (0.665-1.173) | 0.813 (0.600-1.101) | 1.006 (0.662-1.528) | | | SpO2 (%) | | | | | | 0.528 | | <97 | 1212 | 1.0 (ref) | 0.894 (0.658-1.214) | 0.742 (0.532-1.034) | 1.231 (0.788-1.924) | | | ≥97 | 1272 | 1.0 (ref) | 0.976 (0.702-1.357) | 0.977 (0.704-1.355) | 1.043 (0.680-1.600) | | | Temperature (°C) | | | | | | 0.118 | | <36.7 | 1189 | 1.0 (ref) | 1.441 (1.057-1.964) | 1.087 (0.791-1.495) | 1.612 (1.070-2.428) | | | ≥36.7 | 1295 | 1.0 (ref) | 0.657 (0.474-0.910) | 0.764 (0.546-1.069) | 0.879 (0.552-1.402) | | | Heart rate (beats/minute) | | | | | | 0.291 | | <91.4 | 1242 | 1.0 (ref) | 1.008 (0.723-1.407) | 0.777 (0.547-1.104) | 1.335 (0.849-2.101) | | | ≥91.4 | 1242 | 1.0 (ref) | 0.904 (0.671-1.220) | 0.978 (0.722-1.324) | 0.985 (0.651-1.489) | | | MBP (mmHg) | | | | | | 0.037 | | <70.1 | 1234 | 1.0 (ref) | 1.125 (0.837-1.512) | 0.854 (0.622-1.172) | 1.422 (0.932-2.171) | | | ≥70.1 | 1250 | 1.0 (ref) | 0.816 (0.579-1.151) | 0.958 (0.684-1.341) | 0.928 (0.587-1.466) | | | Respiratory rate (beats/minute) | | | | | | 0.428 | | <21.4 | 1336 | 1.0 (ref) | 0.916 (0.667-1.257) | 0.832 (0.598-1.159) | 1.482 (0.966-2.274) | | | ≥21.4 | 1148 | 1.0 (ref) | 0.989 (0.722-1.355) | 0.825 (0.595-1.145) | 0.891 (0.562-1.411) | | | Glucose (mg/dL) | | | | | | 0.624 | | 133.9 | 1242 | 1.0 (ref) | 0.971 (0.710-1.327) | 1.078 (0.781-1.488) | 1.497 (0.982-2.281) | | | ≥133.9 | 1242 | 1.0 (ref) | 0.867 (0.626-1.199) | 0.686 (0.492-0.957) | 0.808 (0.514-1.268) | | | Albumin (g/dL) | | | | | | 0.451 | | <2.7 | 1194 | 1.0 (ref) | 1.171 (0.860-1.595) | 1.083 (0.781-1.500) | 1.538 (1.004-2.355) | | | ≥2.7 | 1290 | 1.0 (ref) | 0.826 (0.594-1.148) | 0.751 (0.542-1.041) | 1.008 (0.659-1.541) | | | Bilirubin (mg/dL) | | | | | | 0.555 | | <0.7 | 1229 | 1.0 (ref) | 0.965 (0.676-1.378) | 0.866 (0.601-1.246) | 1.173 (0.734-1.874) | | | ≥0.7 | 1255 | 1.0 (ref) | 0.935 (0.702-1.245) | 0.848 (0.625-1.151) | 1.031 (0.679-1.564) | | | Bicarbonate (mg/dL) | | | | | | 0.312 | | <22 | 1072 | 1.0 (ref) | 0.965 (0.699-1.332) | 1.012 (0.712-1.438) | 1.032 (0.615-1.731) | | | ≥22 | 1412 | 1.0 (ref) | 0.937 (0.612-1.288) | 0.811 (0.593-1.109) | 1.256 (0.856-1.841) | | | Calcium (mmol/L) | | | | | | 0.981 | | <8.1 | 1172 | 1.0 (ref) | 0.971 (0.700-1.346) | 0.891 (0.618-1.285) | 1.197 (0.717-1.997) | | | ≥8.1 | 1312 | 1.0 (ref) | 0.899 (0.663-1.217) | 0.826 (0.611-1.117) | 1.116 (0.764-1.630) | | | Potassium (mmol/L) | | | | | | 0.231 | | <4.2 | 1107 | 1.0 (ref) | 0.860 (0.602-1.228) | 0.888 (0.614-1.285) | 1.280 (0.759-2.160) | | | ≥4.2 | 1377 | 1.0 (ref) | 1.053 (0.789-1.406) | 0.855 (0.635-1.151) | 1.097 (0.753-1.600) | | | Sodium (mmol/L) | | | | | | 0.098 | | <13.8 | 1222 | 1.0 (ref) | 0.877 (0.641-1.200) | 0.765 (0.555-1.055) | 1.013 (0.652-1.573) | | | ≥13.8 | 1262 | 1.0 (ref) | 1.016 (0.737-1.402) | 0.950 (0.681-1.325) | 1.306 (0.848-2.011) | | | Hematocrit (%) | | | | | | 0.329 | | <33.3 | 1234 | 1.0 (ref) | 0.935 (0.679-1.285) | 0.984 (0.712-1.360) | 1.337 (0.884-2.023) | | | ≥33.3 | 1250 | 1.0 (ref) | 0.933 (0.681-1.277) | 0.769 (0.550-1.074) | 0.928 (0.592-1.455) | | | Anion gap | | | | | | 0.268 | | <15 | 1001 | 1.0 (ref) | 0.935 (0.649-1.349) | 1.234 (0.856-1.777) | 1.700 (1.052-2.748) | | | ≥15 | 1483 | 1.0 (ref) | 0.981 (0.734-1.311) | 0.797 (0.588-1.080) | 1.023 (0.690-1.515) | | | Lymphocytes (%) | | | | | | 0.712 | | <7.1 | 1242 | 1.0 (ref) | 0.837 (0.607-1.154) | 0.881 (0.635-1.222) | 1.095 (0.709-1.693) | | | ≥7.1 | 1242 | 1.0 (ref) | 1.000 (0.730-1.370) | 0.855 (0.613-1.193) | 1.171 (0.770-1.781) | | | Neutrophils (%) | | | | | | 0.308 | | <81.9 | 1219 | 1.0 (ref) | 0.957 (0.684-1.340) | 0.902 (0.641-1.270) | 1.357 (0.874-2.107) | | | ≥81.9 | 1265 | 1.0 (ref) | 0.939 (0.697-1.265) | 0.914 (0.666-1.254) | 1.113 (0.719-1.723) | | | Hours of vasopressor | | | | | | 0.013 | | <34 | 1223 | 1.0 (ref) | 0.989 (0.693-1.413) | 0.739 (0.506-1.081) | 1.268 (0.760-2.117) | | | ≥34 | 1261 | 1.0 (ref) | 1.057 (0.872-1.554) | 1.164 (0.872-1.554) | 1.306 (0.894-1.910) | | | Platelet (109/L) | | | | | | 0.008 | | <214 | 1241 | 1.0 (ref) | 0.782 (0.567-1.079) | 0.824 (0.595-1.142) | 1.312 (0.853-2.017) | | | ≥214 | 1243 | 1.0 (ref) | 1.062 (0.774-1.457) | 0.888 (0.641-1.233) | 0.962 (0.617-1.501) | | | Hemoglobin (g/dL) | | | | | | 0.537 | | <10.8 | 1204 | 1.0 (ref) | 0.665 (0.462-0.958) | 0.638 (0.437-0.931) | 0.931 (0.555-1.560) | | | ≥10.8 | 1280 | 1.0 (ref) | 1.174 (0.886-1.556) | 1.014 (0.776-1.396) | 1.369 (0.932-2.012) | | | Lactate (mmol/L) | | | | | | 0.499 | | <1.3 | 409 | 1.0 (ref) | 0.913 (0.510-1.635) | 0.725 (0.403-1.303) | 0.766 (0.394-1.486) | | | ≥1.3 | 2075 | 1.0 (ref) | 1.042 (0.818-1.327) | 0.942 (0.742-1.195) | 1.238 (0.968-1.583) | | | INR | | | | | | 0.110 | | <1.2 | 898 | 1.0 (ref) | 0.782 (0.529-1.157) | 0.796 (0.533-1.189) | 1.108 (0.667-1.841) | | | ≥1.2 | 1586 | 1.0 (ref) | 1.052 (0.802-1.379) | 0.874 (0.661-1.157) | 1.120 (0.768-1.634) | | | RDW | | | | | | 0.552 | | <15.4 | 1206 | 1.0 (ref) | 0.896 (0.657-1.220) | 0.735 (0.529-1.022) | 0.741 (0.472-1.162) | | | ≥15.4 | 1278 | 1.0 (ref) | 1.014 (0.729-1.409) | 1.028 (0.735-1.438) | 1.678 (1.089-2.585) | | | WBC (109/L) | | | | | | 0.091 | | <11.9 | 1200 | 1.0 (ref) | 0.825 (0.594-1.145) | 0.802 (0.570-1.128) | 1.116 (0.720-1.730) | | | ≥11.9 | 1284 | 1.0 (ref) | 1.149 (0.850-1.553) | 0.917 (0.673-1.248) | 1.245 (0.818-1.894) | | | Chronic pulmonary | | | | | | 0.906 | | Yes | 1889 | 1.0 (ref) | 0.954 (0.585-1.554) | 0.963 (0.580-1.598) | 1.283 (0.674-2.442) | | | No | 595 | 1.0 (ref) | 0.922 (0.717-1.185) | 0.840 (0.647-1.090) | 1.084 (0.767-1.531) | | | Cardiac arrhythmias | | | | | | 0.095 | | Yes | 1066 | 1.0 (ref) | 0.735 (0.520-1.038) | 0.754 (0.529-1.076) | 1.251 (0.789-1.983) | | | No | 1418 | 1.0 (ref) | 1.176 (0.879-1.573) | 0.988 (0.731-1.335) | 1.162 (0.776-1.739) | | | Coagulopathy | | | | | | 0.628 | | Yes | 1710 | 1.0 (ref) | 0.783 (0.521-1.177) | 0.805 (0.534-1.213) | 1.109 (0.639-1.922) | | | No | 774 | 1.0 (ref) | 1.098 (0.839-1.438) | 0.971 (0.733-1.286) | 1.300 (0.892-1.894) | | | Congestive heart failure | | | | | | 0.352 | | Yes | 951 | 1.0 (ref) | 0.791 (0.541-1.156) | 0.876 (0.596-1.287) | 1.261 (0.739-2.154) | | | No | 1533 | 1.0 (ref) | 0.968 (0.735-1.276) | 0.856 (0.643-1.141) | 1.069 (0.744-1.538) | | | Diabetes | | | | | | 0.748 | | Yes | 601 | 1.0 (ref) | 0.845 (0.487-1.474) | 1.243 (0.726-2.127) | 1.368 (0.686-2.727) | | | No | 1883 | 1.0 (ref) | 0.987 (0.773-1.260) | 0.862 (0.667-1.113) | 1.100 (0.781-1.549) | | | Fluid electrolyte | | | | | | 0.621 | | Yes | 1034 | 1.0 (ref) | 0.846 (0.628-1.147) | 0.785 (0.578-1.066) | 1.006 (0.672-1.507) | | | No | 1450 | 1.0 (ref) | 1.142 (0.820-1.591) | 1.060 (0.750-1.496) | 1.462 (0.925-2.312) | | | Hypertension | | | | | | 0.812 | | Yes | 1313 | 1.0 (ref) | 1.085 (0.795-1.481) | 1.017 (0.737-1.404) | 1.528 (0.995-2.348) | | | No | 1171 | 1.0 (ref) | 0.922 (0.666-1.275) | 0.904 (0.644-1.268) | 1.038 (0.660-1.632) | | | Liver disease | | | | | | 0.792 | | Yes | 542 | 1.0 (ref) | 0.924 (0.582-1.468) | 0.999 (0.619-1.611) | 1.093 (0.596-2.006) | | | No | 1942 | 1.0 (ref) | 0.992 (0.766-1.284) | 0.891 (0.682-1.164) | 1.239 (0.862-1.783) | | | Renal failure | | | | | | 0.299 | | Yes | 616 | 1.0 (ref) | 0.906 (0.624-1.315) | 0.785 (0.521-1.182) | 1.049 (0.599-1.835) | | | No | 1868 | 1.0 (ref) | 0.963 (0.727-1.275) | 1.036 (0.781-1.374) | 1.402 (0.967-2.034) | |
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BCR: blood urea nitrogen/creatinine ratio; RRT: renal replacement therapy; CHF: congestive heart failure; RDW: red blood cell distribution width; INR: international normal ratio; WBC: white blood cell count; SOFA: Sequential Organ Failure Assessment score.
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