The role of bilirubin to albumin ratio as a predictor for mortality in critically ill patients without existing liver or biliary tract disease

Ji Soo Choi, Kyung Soo Chung, Eun Hye Lee, Su Hwan Lee, Sang Hoon Lee, Song Yee Kim, Ji Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Joon Chang, Ah Young Leem

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Abstract

Background: Hyperbilirubinemia and hypoalbuminemia are frequently appeared and associated with poor prognosis in critically ill patients. We aim to evaluate the association between the bilirubin to albumin ratio and prognosis in intensive care unit (ICU) patients. Methods: This was a retrospective study of 731 patients who were admitted to the medical intensive care unit (MICU) at a tertiary-care center from July 2015 to September 2017. We analyzed the bilirubin to albumin ratio on admission to the MICU, including clinical characteristics and other examinations. Results: The overall 28-day survival of MICU patients was 69.1%. On univariate analysis, Acute Physiology and Chronic Health Evaluation (APACHE) II score (P<0.001), Sequential Organ Failure Assessment score (P<0.001), Simplified Acute Physiology Score II score (P<0.001), C-reactive protein (P=0.015), and bilirubin/albumin ratio (P<0.001) were associated with mortality of ICU patients. The receiver operating characteristic curves for ICU patients mortality between bilirubin to albumin ratio and APACHE II score were not statistically significant (P=0.282). On multivariate analysis, higher APACHE II score (hazard ratio [HR], 1.05; 95% CI, 1.03 to 1.06; P<0.001) and bilirubin to albumin ratio (HR, 1.65; 95% CI, 1.23 to 2.20; P=0.001) were independently related to the ICU patient mortality. Conclusions: A higher bilirubin to albumin ratio was related to the unfavorable prognosis and mortality in critically ill patients.

Original languageEnglish
Pages (from-to)24-30
Number of pages7
JournalAcute and Critical Care
Volume35
Issue number1
DOIs
Publication statusPublished - 2020 Feb 29

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine
  • Critical Care

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    Choi, J. S., Chung, K. S., Lee, E. H., Lee, S. H., Lee, S. H., Kim, S. Y., Jung, J. Y., Kang, Y. A., Park, M. S., Kim, Y. S., Chang, J., & Leem, A. Y. (2020). The role of bilirubin to albumin ratio as a predictor for mortality in critically ill patients without existing liver or biliary tract disease. Acute and Critical Care, 35(1), 24-30. https://doi.org/10.4266/ACC.2019.00738