Investigation of the relationship between shock index and BUN/Albumin ratio with clinical outcomes in patients presenting to the emergency department with upper gastrointestinal bleeding

This study aimed to evaluate whether the shock index (SI) and blood urea nitrogen (BUN)/albumin ratio (BAR) measured at admission can serve as effective markers for predicting rebleeding and mortality at 28, 90, and 180 days in patients presenting to the emergency department with upper gastrointestinal bleeding (UGIB). In this single-center prospective study, patients with UGIB admitted to a tertiary care emergency department between January 1, 2023, and December 31, 2023, were prospectively analyzed. ROC analysis was conducted to assess the predictive performance of SI and BAR for rebleeding and mortality at 28, 90, and 180 days. A total of 120 patients who met the inclusion criteria were included in the study. The area under the curve (AUC) values for BAR in predicting mortality at 28, 90, and 180 days were 0.83, 0.79, and 0.81, respectively. The corresponding AUC values for the shock index (SI) were 0.66, 0.61, and 0.62. For predicting recurrent upper gastrointestinal bleeding (UGIB) within 28, 90, and 180 days, the AUC values of BAR were 0.74, 0.73, and 0.73, respectively, whereas the AUC values for SI were 0.57, 0.57, and 0.61. In terms of 180-day mortality, age ≥ 65 years [OR: 6.12 (95% CI, 1.86–20.15), p < 0.001] and the presence of comorbidities [OR: 3.79 (95% CI, 1.28–11.27), p < 0.05] were identified as significant risk factors for recurrent UGIB within 180 days. were identified as significant risk factors for recurrent UGIB. In patients with UGIB presenting to the emergency department, BAR demonstrated the highest predictive performance for recurrent UGIB and mortality at 28, 90, and 180 days. Based on these findings, BAR may serve as an effective marker for the follow-up of these patients.