• Mustafa A Tatlisu, Adnan Kaya, Muhammed Keskin, Sahin Avsar, Mehmet Bozbay, Kiymet Tatlisu, and Mehmet Eren.
• Department of Cardiovascular Science, Texas A&M Institute for Preclinical Science, College Station, TX, 77843, USA. Electronic address: ademtatlisu@gmail.com.
• J Crit Care. 2017 Jun 1; 39: 248-253.

BackgroundThe aim of this study was to investigate the association of BUN levels with in-hospital and long-term adverse clinical outcomes in acute pulmonary embolism (APE) patients treated with tissue-plasminogen activator (t-PA).MethodsThis retrospective study included 252 consecutive confirmed APE patients treated with t-PA. An admission BUN of 34.5 mg/dL was identified through an ROC analysis as an optimal cutoff value to predict the in-hospital mortality with 85% sensitivity and 91% specificity (AUC: 0.91; 95% CI: 0.84-0.96; P<.001).ResultsOur study showed that an increase in BUN levels was independently associated with a high risk of in-hospital all-cause mortality, low admission systolic blood pressure, use of inotropic drugs, and cardiogenic shock. In-hospital mortality rates were 51.1% in higher BUN group, and 1.9% in lower BUN group (P<.001).ConclusionIn this study, elevated admission BUN level was found to be a predictor of all-cause in-hospital mortality. BUN testing is commonly part of the basic metabolic panel; and it can be used to detect high-risk patients with APE, and it bears little risk, is inexpensive, and easy to perform.Published by Elsevier Inc.

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