Association between total bilirubin/Albumin ratio and all-cause mortality in acute kidney injury patients: A retrospective cohort study

PLoS One. 2023 Nov 1;18(11):e0287485. doi: 10.1371/journal.pone.0287485. eCollection 2023.

Abstract

Background: The association between the total bilirubin/albumin (B/A) and the all-cause mortality of critically ill patients with acute kidney injury (AKI) remains unclear. This retrospective study aimed to investigate the relationship between B/A ratio and mortality in patients with AKI.

Methods: The clinical data of AKI patients in the Medical Information Mart for Intensive Care III (MIMIC-III) database were retrospectively analyzed. Patients were divided into the low and high B/A groups (B/A ≤ 0.25 and B/A > 0.25, respectively). The primary outcome was 28-day all-cause mortality, and the secondary outcomes were 60-day, 1-year and 4-year all-cause mortality. Kaplan-Meier survival curves and Cox proportional risk models were constructed to evaluate the effect of B/A on survival outcomes.

Results: The 28-day mortality rates were 18.00% and 25.10% in the low and high B/A groups, respectively (P < 0.001). The Kaplan-Meier analysis showed that patients with higher B/A values had higher all-cause mortality risk (log-rank P < 0.0001). The multivariate Cox proportional risk analysis showed that B/A was an independent risk predictor for death at 28 days, 60 days, 1 year, and 4 years.

Conclusion: B/A is an independent risk factor for increased mortality in patients with AKI and may be used as a predictor of clinical outcomes in AKI.

MeSH terms

  • Acute Kidney Injury* / etiology
  • Critical Care*
  • Critical Illness
  • Humans
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies

Grants and funding

The authors received no specific funding for this work.