The impact of BAR in conjunction with PaO2/FiO2 on the prognosis of elderly individuals suffering from severe pneumonia

Tengli Ren ^*

• Shanxi Medical University, Taiyuan, China

Objective:This study sought to determine how well the partial pressure of arterial oxygen to the concentration of inspired oxygen (PaO2/FiO2) and the urea nitrogen to albumin ratio (BUN to Albumin Ratio, BAR) combined to predict the prognosis of elderly patients with severe pneumonia. Methods: Within 24 hours of admission, the BUN, albumin, and PaO2/FiO2 values of 273 elderly patients with severe pneumonia were assessed for this study. Depending on their survival status after 28 days, the patients were split into survival and death groups. The diagnostic effectiveness of the aforementioned markers on the patients' prognosis was evaluated in this study using Receiver Operating Characteristic Curve (ROC Curve) analysis.Results:The study's findings showed that the death group's median BAR was 10.74, significantly higher than the survival group's 5.16, and the death group's median PaO2/FiO2 was 137.40 mmHg, lower than the survival group's 223.33 mmHg. The differences between the two groups were statistically significant (P < 0.001). The results of the univariate analysis showed that the deceased group had higher levels of incidence of infection with two or more types of pathogensplasma 、plasma white blood cell count (WBC), neutrophil count (NEU), BUN, neutrophil-to-lymphocyte ratio (NLR), ratio of erythrocyte distribution width to mean erythrocyte volume (RAR), and BAR than the surviving group (P < 0.05). In the meanwhile, the death group had lower levels of BMI、length of stay、albumin and PaO2/FiO2 than the survival group, and the differences were statistically significant (P < 0.05). BAR and PaO2/FiO2 were independent risk variables for the outcome of older patients with severe pneumonia, according to multivariate regression analysis (OR 1.248 and 0.987, respectively, P < 0.001).According to ROC curve analysis, the best combination for early prognostic prediction of elderly patients with severe pneumonia was BAR plus PaO2/FiO2 (AUC = 86.1%). Conclusion: When evaluating the risk of death in elderly patients suffering from severe pneumonia, BAR, PaO2/FiO2, and their combination tests can be utilized as quick, easy, and possibly useful prognostic techniques.Keywords: diagnosis, prognosis, severe pneumonia in the elderly, BAR, and PaO2/FiO2.