BEYOND CONVENTIONAL MARKERS: EXPLORING THE BLOOD UREA NITROGEN TO SERUM ALBUMIN RATIO AS A POTENTIAL PREDICTOR IN COMMUNITY-ACQUIRED PNEUMONIA PROGNOSIS

Abstract

Objectives To evaluate the diagnostic accuracy of BUN/albumin, in predicting the severity of CAP, keeping actual severity (ICU admission and mortality within 30 days) as gold standard and to compare the diagnostic accuracy of the BUN/albumin with CURB-65 keeping actual severity (ICU admission and mortality within 30 days) as gold standard.

Study Design: Cross-sectional study.

Study Setting and Duration: Conducted at a tertiary care hospital from May -Aug 2025. Methods: A total of 236 patients aged 18–65 years diagnosed with CAP were included. Serum BUN and albumin levels were measured at admission, and the BUN/albumin ratio was calculated. CURB-65 scores were determined for all patients. Both the predictors were evaluated/compared for their diagnostic accuracy by applying ROC curve analysis and 2x2 table keeping the gold standard of 30-ay mortality and ICU admission.

Results: The BUN/albumin ratio demonstrated excellent diagnostic accuracy in predicting ICU admission, with high sensitivity and specificity. It also showed good performance in predicting 30-day mortality. CURB-65 exhibited higher sensitivity for mortality prediction but lower specificity compared to the BUN/albumin ratio. Overall, the BUN/albumin ratio showed a more balanced diagnostic profile.

Conclusion: The BUN/albumin ratio is a simple, cost-effective, and reliable biomarker for predicting severity and outcomes in CAP. When used alongside CURB-65, it may enhance early risk stratification and support clinical decision-making.