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The piece evaluates biological meaning, clinical practicality, confounding influences, and apparent inconsistency of BCR associations with outcomes, concluding that further clarification is warranted.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/blood-urea-nitrogen-and-creatinine-in-in-hospital-cardiac-arrest-patients-editorial/436706/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/blood-urea-nitrogen-and-creatinine-in-in-hospital-cardiac-arrest-patients-editorial/436706.png","ImageObject",300,407,{"name":42,"@type":43},"Angel","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why are biomarkers such as BUN, Cr, and BCR important in IHCA?","Question",{"text":63,"@type":64},"IHCA after unexpected clinical deterioration can lead to major uncertainty in prognosis and treatment decisions. Reliable biomarkers are needed to relate resuscitation course and post-resuscitation outcomes to mortality and morbidity.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What did earlier research suggest about BCR after targeted temperature management?",{"text":68,"@type":64},"Elevated post-TTM and intra-arrest BCR were associated with worse neurological outcomes at discharge, with a reported post-TTM BCR cutoff value to predict poor neurological outcome.",{"name":70,"@type":61,"acceptedAnswer":71},"What concerns are raised about using BUN, Cr, and BCR in routine practice?",{"text":72,"@type":64},"The editorial notes that these simple laboratory measures are influenced by multiple confounding factors and may be misinterpreted, which can affect judgment of diagnosis and disease severity. It also states that the role of BCR appeared inconclusive or inconsistent in the presented evidence.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},436706,1791321189,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":97,"preview_page_count":4},687207412472,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","J Chin MedAssoc  \nEDITORIAL  \nBlood urea nitrogen and creatinine in in-hospital cardiac arrest patients  \nWen-Ling Leea,b,c, Fa-Kung Leed,e, Peng-Hui Wangb,e,f,g,*  \naDepartment of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cDepartment of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC; dDepartment of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan, ROC; eFemale Cancer Foundation, Taipei, Taiwan, ROC; fDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; gDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC  \nWhen unexpected clinical deterioration, such as in-hospital cardiac arrest (IHCA) or sudden death, occurs in hospitalization patients, especially for those patients who have not been recognized with a terminal disease (a clinical situation showing an irreversible and continuously deteriorated patient’s health accompanied with an expectedly shortly lifespan) or who do not sign the do-not-resuscitate (DNR) orders, regardless whether the cause is, poses a biggest and extraordinary challenge for a psychosocial emergency, which may result in many uncertainties, including the decision to withhold and withdraw life-sustaining treatment or the following legal issues.1,2 Therefore, many efforts will be initiated immediately for those IHCA patients to save their lives, if DNR orders are not obtained. Some patients may prolong life due to giving the presence of technological advances, but post-resuscitation outcomes may be critical. Therefore, more powerful and accurate biomarkers and/or clinical parameters are urgently needed to determine what situations may be associated with mortality as well as with developing post-resuscitation morbidity while surviving.3–5 In theory, similar to all other diseases,5–9 an early identification of risk factors associated with IHCA and an offering the prompt and effective treatment may decrease the IHCA-related morbidity and mortality. The recent publication in the last October issue of the Journal of the Chinese Medical Association entitled “Prognostic significance of the blood urea nitrogen to creatinine ratio in in-hospital cardiac arrest after targeted temperature management,”attempted to use the simple parameters of blood urea nitrogen (BUN) to creatinine (Cr) ratio (BCR) to predict the neurological outcome at discharge among IHCA patients receiving  \n* Address correspondence. Dr. Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail addresses: phwang@vghtpe.gov.tw](ROC. E-mail addresses: phwang@vghtpe.gov.tw); [pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang).  \nConflicts of interest: Dr. Peng-Hui Wang, an editorial board member at the Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 1-2.  \nReceived November 1, 2022; accepted November 4, 2022.  \ndoi: 10. 1097/JCMA.0000000000000847.  \nCopyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \ntargeted temperature management (TTM) .10 The authors found that elevated post-TTM BCR was a significant predictor (adjusted odd ratio [aOR], 1.081; 95% confidence interval [CI], 1.002-1. 165) and elevated intra-arrest BCR was a marginal predictor (aOR, 1.067; 95% CI, 1.000-1.138) for worse neurological outcomes at discharge among IHCA patients.10 Additional","cbCaivOtPvTeTeXX","https://ap.wps.com/l/cbCaivOtPvTeTeXX","pdf",292546,"English","# Editorial\n## Clinical challenge of IHCA and need for biomarkers\n## Prior evidence on BCR after targeted temperature management\n## Interpretation of BUN, Cr, and BCR as biomarkers\n## Practical testing, confounding factors, and outcome inconsistency","[{\"question\":\"Why are biomarkers such as BUN, Cr, and BCR important in IHCA?\",\"answer\":\"IHCA after unexpected clinical deterioration can lead to major uncertainty in prognosis and treatment decisions. Reliable biomarkers are needed to relate resuscitation course and post-resuscitation outcomes to mortality and morbidity.\"},{\"question\":\"What did earlier research suggest about BCR after targeted temperature management?\",\"answer\":\"Elevated post-TTM and intra-arrest BCR were associated with worse neurological outcomes at discharge, with a reported post-TTM BCR cutoff value to predict poor neurological outcome.\"},{\"question\":\"What concerns are raised about using BUN, Cr, and BCR in routine practice?\",\"answer\":\"The editorial notes that these simple laboratory measures are influenced by multiple confounding factors and may be misinterpreted, which can affect judgment of diagnosis and disease severity. It also states that the role of BCR appeared inconclusive or inconsistent in the presented evidence.\"}]","Blood urea nitrogen and creatinine in in-hospital cardiac arrest patients - Editorial | PDF",1790678795]