The association of blood urea nitrogen to serum albumin ratio with short-term outcomes in Chinese patients with congestive heart failure: A retrospective cohort study

Background and Aims: Limited evidence exists on the prognostic outcomes of the blood urea nitrogen to serum albumin ratio (B/A ratio) in congestive heart failure (CHF), particularly in developing countries with scarce heart failure epidemiological data.We aimed to investigate the association between B/A ratio and short-term outcomes in Chinese patients with CHF. Methods and Results:We included 1761 CHF patients with available B/A ratio data from a cohort of 2008 patients.Patients were categorized into three groups based on B/A ratio (low to high).The primary endpoint was death or readmission within 28 days, and the secondary endpoint was death or readmission within 90 days.We employed restricted cubic spline analysis, Cox proportional hazards regression, and Kaplan-Meier curves to evaluate the relationship between B/A ratio at admission and the endpoints.Even after adjusting for other variables, higher B/A ratios were associated with increased rates of 28 days and 90 days mortality or readmission (HR: 2.4, 95% CI:1.81-3.18and HR: 1.74, 95% CI: 1.48-2.05).Significant differences in the risks of both primary and secondary endpoints were observed among the three B/A ratio groups.The association between B/A ratio and CHF was stable in the different subgroups (all P for interaction＞0.05). Conclusion:Higher B/A ratios are associated with an increased risk of short-term mortality or readmission in Chinese patients with CHF.The B/A ratio shows promise as a prognostic indicator for short-term outcomes in CHF patients.