Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026
Blood urea nitrogen-to-albumin ratio as a predictor of mortality in patients undergoing emergency surgery for obstructive colon cancer.
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Aday Ulas, Akbaş Abdulkadir, Özesmer Hikmet, Dağ Ömer Serhat, Gedik Ercan, Gündeş Ebubekir, Akkoc Hasan
Аннотация
BACKGROUND: Mortality rates are high in patients undergoing emergency surgery for obstructed colon adenocarcinoma. The etiology of mortality is multifactorial, and parameters with high predictive value are still needed. The aim of this study was to investigate the relationship between the blood urea nitrogen-to-serum albumin ratio (BAR) and short-term mortality in patients with obstructed colon cancer undergoing emergency surgery.
METHODS: This retrospective cohort study included patients with obstructed colon adenocarcinoma who underwent emergency surgery at two tertiary care centers between January 2015 and December 2024. Baseline characteristics, laboratory findings, operative details, and clinical data were collected. According to time-dependent receiver operating characteristics (ROC) analysis, the optimal cut-off value for pretreatment BAR was 0.68. Data from patients who died within the first 30 days and those who survived were compared. Univariate and multivariate Cox regression analyses were performed to evaluate the association between BAR and other factors with early mortality.
RESULTS: A total of 173 patients underwent emergency surgery, and 17 (9.8%) experienced early mortality. In multivariate logistic regression analysis, age (≥75 years), lactate level, neutrophil count, and BAR ≥0.68 (odds ratio: 7.053; 95% confidence interval: 1.728-28.785; p=0.006) were identified as significant risk factors for early mortality in patients undergoing emergency surgery for obstructed colon cancer.
CONCLUSION: Mortality in patients undergoing emergency surgery for obstructed colon cancer is high and multifactorial. BAR is a cost-effective, easily measurable, and useful predictor of early mortality.
METHODS: This retrospective cohort study included patients with obstructed colon adenocarcinoma who underwent emergency surgery at two tertiary care centers between January 2015 and December 2024. Baseline characteristics, laboratory findings, operative details, and clinical data were collected. According to time-dependent receiver operating characteristics (ROC) analysis, the optimal cut-off value for pretreatment BAR was 0.68. Data from patients who died within the first 30 days and those who survived were compared. Univariate and multivariate Cox regression analyses were performed to evaluate the association between BAR and other factors with early mortality.
RESULTS: A total of 173 patients underwent emergency surgery, and 17 (9.8%) experienced early mortality. In multivariate logistic regression analysis, age (≥75 years), lactate level, neutrophil count, and BAR ≥0.68 (odds ratio: 7.053; 95% confidence interval: 1.728-28.785; p=0.006) were identified as significant risk factors for early mortality in patients undergoing emergency surgery for obstructed colon cancer.
CONCLUSION: Mortality in patients undergoing emergency surgery for obstructed colon cancer is high and multifactorial. BAR is a cost-effective, easily measurable, and useful predictor of early mortality.