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The following is a summary of “Importance Of Uric Acid Levels In Geriatric Patients With Respiratory Failure Under Noninvasive Mechanical Ventilation In the Respiratory Intensive Care Unit,” published in the March 2025 issue of BMC Pulmonary Medicine by Yıldız et al.

The respiratory system plays an essential role in maintaining effective gas exchange, and respiratory failure—characterized by inadequate oxygenation and/or carbon dioxide elimination—remains a significant cause of morbidity and mortality, especially among older adults. Serum uric acid (SUA), a metabolite of purine degradation, is known to accumulate under hypoxic conditions and has been proposed as a potential biomarker for prognosis in various critical illnesses. This retrospective study aimed to assess the prognostic value of SUA levels in relation to mortality, length of hospitalization, and clinical severity scores—namely, the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA)—in geriatric patients with respiratory failure who received non-invasive mechanical ventilation (NIV). 

Data were obtained from 1,109 patients admitted to the Respiratory Intensive Care Unit (RICU) between 2020 and 2022. Exclusion criteria included age under 18, incomplete clinical records, prior diagnosis of gout, and end-stage renal disease requiring dialysis or sustained renal replacement therapy. Patients were stratified into two age-based cohorts: those aged 65 years and older, and those younger than 65. The study evaluated demographic variables, comorbidities, laboratory findings, and ICU severity scores. Statistical analyses, including chi-square tests, correlation coefficients, and regression modeling, were employed to investigate the associations between SUA levels and clinical outcomes. The findings revealed that elderly patients (≥65 years) demonstrated significantly elevated SUA, creatinine, and blood urea nitrogen levels in comparison to their younger counterparts. 

They also exhibited longer hospital stays and higher APACHE II and SOFA scores, suggesting more severe illness. Importantly, elevated SUA was positively correlated with an increase in-hospital mortality and a higher likelihood of requiring NIV support. Regression analysis further confirmed that SUA was an independent predictor of the need for NIV in this population. These results align with prior research highlighting hyperuricemia as a marker of poor prognosis in patients who are critically ill, particularly those with hypoxemic respiratory conditions. The study underscores the clinical relevance of monitoring SUA levels in elderly individuals experiencing respiratory failure, suggesting that elevated SUA may serve as a readily accessible and cost-effective indicator for identifying patients with high risk who are more likely to require intensive respiratory support and face worse outcomes. Incorporating SUA into routine assessment protocols may enhance clinical decision-making and optimize resource allocation in critical care settings. 

In conclusion, serum uric acid levels offer valuable prognostic insight into geriatric patients with respiratory failure and should be considered as part of comprehensive risk stratification and management strategies in the respiratory intensive care unit.

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-025-03603-2