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Golam Forhad Zilani

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Open access Aug 2026

Association of Blood Urea Nitrogen to Serum Albumin Ratio with the Need for Non-invasive Ventilation in Patients with Exacerbation of Chronic Obstructive Pulmonary Disease

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of chronic morbidity and mortality, with frequent exacerbations that can lead to acute respiratory failure. Non-invasive ventilation (NIV) is a key treatment for acute respiratory failure in COPD exacerbations. The Blood Urea Nitrogen (BUN) to serum albumin ratio has been proposed as a prognostic marker in various diseases, reflecting metabolic stress and systemic inflammation. Still, its association with the need for NIV in COPD exacerbations has not been widely studied. Objective: This study aims to evaluate the association between the BUN/Albumin ratio and the need for NIV in patients with exacerbations of COPD. Methods: This cross-sectional study was conducted in the inpatient Department of Respiratory Medicine at the National Institute of Diseases of the Chest and Hospital (NIDCH), Dhaka, Bangladesh, from June 2023 to December 2024. A total of 116 patients diagnosed with exacerbations of COPD were enrolled. The BUN/Albumin ratio was measured for each patient, and the need for NIV was assessed. Data were analysed to determine if there was a significant association between the BUN/Albumin ratio and the requirement for NIV. Results: The mean BUN/Albumin ratio was significantly higher in patients who required NIV (9.1±2.8) compared to those who did not (5.3±1.8, p = 0.001). A progressive increase in the BUN/Albumin ratio was observed with worsening severity of COPD exacerbations, with severe cases showing the highest ratios (9.5±2.9). Multivariate regression analysis showed that the BUN/Albumin ratio was significantly associated with the need for NIV (adjusted OR 19.629, 95% CI 13.976-27.561, p = 0.001). Conclusion: The BUN/Albumin ratio is significantly associated with the need for NIV in patients with exacerbations of COPD. Elevated BUN/Albumin ratios may serve as a useful biomarker for identifying patients at higher risk for respiratory failure and may help guide early intervention in clinical practice. Chest Heart J. 2025; 49(1) : 3-9

Md Shahjahan Ali, Mahmud Rahim, Rezaul Haque et al. · 0 citations
Open access Aug 2026

Utility of the Fifteen Steps Climbing Exercise Oximetry Test in Assessing Disease Severity in Stable COPD Patients- A Cross Sectional Study

Background: Forced Expiratory Volume in the first second (FEV1) from spirometry is essential in diagnosing and managing COPD. Early detection of severe COPD in primary care is vital for timely referral and treatment. Spirometry is often underutilized in rural areas due to limited resources. The Fifteen Steps Climbing Exercise Oximetry Test (15SCT) offers an alternative for assessing COPD severity. Objective: To evaluate the efficacy of 15SCT in determining disease severity in stable COPD patients. Methods: This cross-sectional study was conducted at the National Institute of Diseases of the Chest and Hospital (NIDCH) from June 2022 to August 2023, involving 116 stable COPD patients. Spirometry confirmed COPD diagnosis and severity grading. Pulse, respiratory rate, and oxygen saturation (SpO2) were measured pre- and post-15SCT. Data were analyzed using SPSS v.23, employing Paired t-test, Unpaired t-test, and ROC curve analysis. Results: Patients (mean age 61.3±8.1 years; M:F = 22.2:1) showed moderate (50.0%), severe (43.1%), very severe (5.2%) and mild (1.7%) COPD. Most patients (52.6%) took 61-90 seconds for 15SCT. Post-15SCT SpO2 significantly decreased from baseline (92.9±2.3% vs. 96.3±1.3%; p<0.05). Patients with FEV1<50% had higher SpO2 reduction (4.37±1.12%) than those with FEV1 ³50% (2.51±0.96%). ROC analysis identified a ³3.5% SpO2 drop as indicative of severe airflow limitation with good sensitivity (80.4%), specificity (90.0%) positive predictive value (88.2%), and negative predictive value (83.1%). Conclusion: Significant exercise-induced desaturation correlated with COPD severity, supporting 15SCT as a useful tool for predicting severe airflow limitation in stable COPD patients. Chest Heart J. 2024; 48(1) : 12-18

Tasnuba Tahsin Tofa, Mahmud Rahim, Md Zahirul Islam et al. · 0 citations