The prognostic implication of serum albumin and BUN/Albumin ratio in assessing severity and mortality in community acquired pneumonia (CAP)

Abstract

Introduction and Aim: Community Acquired Pneumonia (CAP) is one of the most important causes of death in pneumonia patients. Most of the CAP patients hospitalized end up with severe complications. So the requirement of ICU in CAP patients is the most challenging decision to be taken on the part of physicians. This study was carried out to evaluate the necessity of serum albumin level and Blood Urea Nitrogen (BUN)/Albumin ratio in the assessment of ICU need and death within one month of admission in CAP patients. Materials and Methods: Patients who were suffering and hospitalized for CAP were taken into the study. Venous blood samples were collected to determine albumin levels and to calculate BUN/Alb ratio. The levels of these parameters were correlated with the need of ICU and death within one month in these patients. Results: 63 patients diagnosed and hospitalized with community acquired pneumonia were taken into the in the study. Patients who had lower serum albumin and higher BUN/Albumin ratio, had the necessity of ICU treatment. The level of BUN/Albumin ratio in determining ICU necessity was found to be ≥12.94. The sensitivity was 91.30% and the specificity 65.79%. Decreased albumin level was an independent risk factor for the necessity of ICU management (OR: 4.152, 95% CI: 0.814 to 0.971, p<0.001). The level of albumin in assessing the necessity of ICU management was found to be ≤3.2g/dl. Conclusion: Patients who had decreased serum albumin and increased BUN/Albumin ratio had the necessity of ICU management. Decreased level of albumin is an self-determining biochemical parameter for determining ICU requirement and assessing prognosis in CAP.