Blood Urea Nitrogen to Albumin Ratio in Acute Pancreatitis: A Potential Supportive Marker for Early Triage between Ward and Intensive Care

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BACKGROUND/AIMS:This study aimed to evaluate the prognostic significance of the blood urea nitrogen (BUN) to albumin ratio (BAR) in patients with acute pancreatitis (AP) by comparing the clinical, biochemical, and hematological profiles of patients directly admitted to the ward and the intensive care unit (ICU).Unlike previous studies that primarily evaluated BAR in critically ill populations or focused on mortality outcomes, the present study investigates its potential role in the early clinical assessment of AP by comparing ward and ICU patients. MATERIALS AND METHODS:This study was a retrospective, single-center analysis of the medical records of patients with AP admitted to the ward or the ICU.Biochemical and hematological data, including BAR values, were obtained from initial laboratory measurements at hospital admission.Patients were stratified into two groups based on their initial admission location; comparisons between groups were performed using appropriate statistical tests to assess the relationship between BAR levels and illness severity.RESULTS: Among the 111 patients included (59 ward and 52 ICU), BAR levels were found to be significantly higher in those requiring ICUlevel care (p=0.001).Receiver operating characteristic (ROC) analysis demonstrated that BAR exhibited good discriminatory performance in distinguishing patients admitted to the ICU from those admitted to the ward (area under the curve =0.836), supporting its potential role as a marker for early risk stratification.CONCLUSION: BAR is a simple, cost-effective biomarker that may support early risk stratification in patients with AP.Elevated BAR levels at admission may help identify patients who require closer monitoring or ICU-level care.The favorable discriminative performance observed in ROC analysis suggests that BAR may complement, rather than replace, clinical assessment in early decision-making.However, prospective multicenter studies are needed to validate these findings and establish optimal cut-off values.

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