Non-linear relationship between blood urea nitrogen to albumin (BUN/ALB) ratio and 3-month outcomes with acute ischemic stroke: a second analysis based on a prospective cohort study

Abstract

Abstract Objective There is still little evidence on the relationship between blood urea nitrogen to albumin (BUN/ALB) ratio and 3-month outcomes in patients with acute ischemic stroke (AIS). Therefore, this study aimed to explore the association between BUN/ALB ratio and 3-month poor outcomes in AIS patients. Methods A retrospective study of 1868 AIS participants was conducted in a Korean hospital from January 2010 to December 2016. Binary logistic regression, smooth curve fitting, and subgroup sensitivity analysis were used to analyze the association between BUN/ALB ratio and 3-month poor outcomes. Results After adjusting covariates, the results of the binary logistic regression model suggested that the relationship between the BUN/ALB ratio and the risk of 3-month poor outcomes for AIS patients was not statistically significant in model II. However, there was a special nonlinear relationship between them, and the inflection point of the BUN/ALB ratio was 0.326. On the left side of the inflection point, 0.1-unit increase in the BUN/ALB ratio reduces the risk of 3-month poor outcomes by 42% (OR = 0.58, 95% CI: 0.40 to 0.83, P = 0.0033). On the right side of the inflection point, the relationship is not statistically significant. Conclusion There is a nonlinear relationship with saturation effect between BUNALB ratio and 3-month poor outcomes in AIS patients. Maintaining a patient's BUN/ALB ratio of around 0.326 can reduce the risk of 3-month poor outcome in AIS patients.