Does Baseline Bun Have An Additive Effect on the Prediction of Mortality in Patients With Acute Pulmonary Embolism?

Background: in patients with heart failure, elevated levels of blood urea nitrogen (bun) is a prognostic factor. in this study, we investigated the prognostic value of elevated baseline bun in short-term mortality among patients with acute pulmonary embolism (pe). methods: between 2007 and 2014, cardiac biomarkers and bun levels were measured in patients with acute pe. the primary endpoint was 30-day mortality, evaluated based on the baseline bun (≥14 ng/l) level in 4 groups of patients according to the european society of cardiology’s risk stratification (low-risk, intermediate low-risk, intermediate high-risk, and high-risk). results: our study recruited 492 patients with a diagnosis of acute pe (mean age=60.58±16.81 y). the overall 1-month mortality rate was 6.9% (34 patients). elevated bun levels were reported in 316 (64.2%) patients. a high simplified pulmonary embolism severity index (spesi) score (or: 5.23, 95% ci: 1.43–19.11; p=0.012), thrombolytic or thrombectomy therapy (or: 2.42, 95% ci: 1.01–5.13; p=0.021), and elevated baseline bun levels (or: 1.04, 95% ci: 1.01–1.03; p=0.029) were the independent predictors of 30-day mortality. according to our receiver-operating characteristics analysis for 30-day mortality, a baseline bun level of greater than 14.8 mg/dl was considered elevated. in the intermediate-low- risk patients, mortality occurred only in those with elevated baseline bun levels (7.2% vs. 0; p=0.008). conclusion: an elevated baseline bun level in our patients with pe was an independent predictor of short-term mortality, especially among those in the intermediate-risk group.