{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:05:47Z","timestamp":1784311547834,"version":"3.55.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2026JJ81088"],"award-info":[{"award-number":["2026JJ81088"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientific Research Fund of Hunan Provincial Education Department","award":["25B0329"],"award-info":[{"award-number":["25B0329"]}]},{"name":"Hunan Provincial Social Science Achievement Committee Project","award":["XSP25YBC286"],"award-info":[{"award-number":["XSP25YBC286"]}]},{"name":"Hunan Provincial Society of Health Economics and Information Research Project","award":["WJX2025B12"],"award-info":[{"award-number":["WJX2025B12"]}]},{"name":"Scientific Research Fund of Hunan Provincial Education Department","award":["24B0369"],"award-info":[{"award-number":["24B0369"]}]},{"name":"National College Student Innovation and Entrepreneurship Training Program","award":["s202410541133"],"award-info":[{"award-number":["s202410541133"]}]},{"name":"Scientific Research Project of Hunan University of Chinese Medicine","award":["2025XJZC007"],"award-info":[{"award-number":["2025XJZC007"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Given the high mortality associated with cardiogenic shock (CS), this study aimed to evaluate the association between the blood urea nitrogen-to-albumin ratio (BAR) and mortality in critically ill patients with CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>The data of this retrospective study were extracted from the Medical Information Mart for Intensive CARE-IV (MIMIC-IV v2.2) database. Patients who were diagnosed with CS were included as the study population. The primary outcome was one-year mortality, and secondary outcomes included in-hospital mortality and ICU mortality. Cox regression models were used to estimate the association between BAR and mortality.The prognostic value of BAR was assessed using the time-dependent area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1,177 patients were enrolled in the study. After adjustment for covariates, BAR was associated with one-year mortality (HR: 1.02 [1.01\u20131.03],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 per 1-unit increase). Compared with the low-BAR group, the medium- and high-BAR groups showed higher risks of one-year mortality (medium group: HR 1.30 [1.02\u20131.66],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.034; high group: HR 1.75 [1.32\u20132.33],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Similar associations were observed for in-hospital mortality (per 1-unit increase: HR 1.02 [1.01\u20131.04],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; high vs. low group: HR 1.51 [1.08\u20132.13],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.017) and ICU mortality (per 1-unit increase: HR 1.02 [1.01\u20131.04],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001; high vs. low group: HR 1.67 [1.17\u20132.40],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005). E\u2011value analysis suggested robustness to unmeasured confounding. BAR demonstrated favorable discriminative ability, with a time\u2011dependent AUC of 0.612 and a Harrell\u2019s C\u2011index of 0.607. When combined with existing prognostic indicators, BAR significantly improved prognostic accuracy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, higher BAR levels were associated with increased mortality in CS patients. BAR provided incremental prognostic value when combined with existing indicators.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0352659","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:48:43Z","timestamp":1784310523000},"page":"e0352659","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Blood urea nitrogen to albumin ratio and mortality in critically ill patients with cardiogenic 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