Postoperative hypoalbuminemia as a risk factor for surgical site infection after oral cancer surgery

Lee, Ji; Kwon, MiYoung; Jl, Roh; Jw, Choi; Choi, Sung‐Woon; Sy, Nam; Sy, Kim

doi:10.1111/odi.12232

Cited by 58 publications

(34 citation statements)

References 33 publications

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“…Although many studies have focused on serum albumin before surgery, Hubner et al [9] showed an early postoperative albumin drop to be related to adverse clinical outcomes. Lee et al [26] found that after oral cancer surgery, patients with postoperative hypoalbuminemia were at risk of surgical site infection. Hypoalbuminemia is thought to be associated with inflammation or previous malnutrition [27].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery

Cao

Wang

et al. 2017

World J Surg Onc

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BackgroundThe ratio of C-reactive protein to albumin, as a novel inflammation-based prognostic score, is associated with outcomes in cancer and septic patients. The diagnostic accuracy of the CRP/albumin ratio has not been assessed in colorectal surgery for postoperative complications.MethodsA total of 359 patients undergoing major colorectal surgery between 2012 and 2015 were eligible for this study. Uni- and multivariate analyses were performed to identify risk factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and diagnostic accuracy of the CRP/albumin ratio and postoperative CRP levels.ResultsAmong all the patients, 139 (38.7%) were reported to have postoperative complications. The CRP/albumin ratio was an independent risk factor for complications (OR 4.413; 95% CI 2.463–7.906; P < 0.001), and the cutoff value was 2.2, which had a higher area under the curve compared to CRP on postoperative day 3 (AUC 0.779 vs 0.756). The CRP/albumin ratio also had a higher positive predictive value than CRP levels on postoperative day 3. Patients with CRP/albumin ≥2.2 suffered more postoperative complications (60.8% vs 18.6%, P < 0.001), longer postoperative stays (10 (4–71) vs 7 (3–78) days, P < 0.001), and increased surgical site infections (SSIs) (21.1% vs 4.8%, P < 0.001) than those with CRP/albumin <2.2.ConclusionsThe ratio of C-reactive protein to albumin could help to identify patients who have a high probability of postoperative complications, and the ratio has higher diagnostic accuracy than C-reactive protein alone for postoperative complications in colorectal surgery.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery

Cao

Wang

et al. 2017

World J Surg Onc

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“…However, low postoperative albumin is affected by many factors. Ge X et al noted that the stress response, perioperative fluid overload, hemodilution, albumin redistribution, a breakdown of metabolism and other comprehensive factors cause postoperative albumin decline [36].Despite this, we still need to be wary of hypoalbuminemia with albumin levels < 3.0 g/dl after surgery.…”

Section: Resultsmentioning

confidence: 99%

Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

Zhou

Zhong

et al. 2020

Preprint

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Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence ( SWD ) group and a normal wound healing group, and into an surgical site infection(SSI)group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses. Results: A total of 554 patients were enrolled in the study.The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl and postoperative serum albumin:<3.0 g/dl were significantly related to SWD (P<0.05). There were also significant differences between the surgical site infection (SSI) groups in terms of preoperative serum albumin <3.5 g/dl(P=0.001), postoperative serum albumin <3.5 g/dl (P<0.023) and <3.0 g/dl(P<0.001).Additionally, the increased hospitalization costs and length of hospitalization were statistically significant for patients with perioperative hypoproteinemia. Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to steroid use,perioperative hypoalbuminemia, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs. Keywords: hypoalbuminemia,malnutrition,risk factors,single-segment lumbar fusion,postoperative incision complications,retrospective studies.

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“…Lee JI et al investigated 337 patients with major oropharyngeal squamous cell carcinoma who underwent clean and contaminated surgery and monitored serum albumin, glucose, and hemoglobin levels during the perioperative period. The results showed that early postoperative hypoalbuminemia <2.5 g/dl was an independent risk factor for SSI in patients who underwent oral cancer surgery [36]. Bohl DD et al also reported that malnutrition increased the risk of periprosthetic joint infection following total joint arthroplasty [37].…”

Section: Discussionmentioning

confidence: 98%

Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

Zhou

Tang

et al. 2020

Preprint

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Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease. Material and methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence (SWD) group and a normal wound healing group, and into a surgical site infection (SSI) group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.Results: A total of 554 patients were enrolled in the study. The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl (P =0.001) and postoperative serum albumin <3.0 g/dl (P =0.001) were significantly correlated to SWD. There were also significant differences between the SSI groups in terms of preoperative serum albumin <3.5 g/dl (P=0.001), Chronic steroid use (P=0.003). Additionally, the increased hospitalization costs (P<0.001) and length of hospitalization (P<0.001) were statistically significant for patients with perioperative hypoalbuminemia. Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to perioperative hypoalbuminemia and chronic steroid use,which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.

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Postoperative hypoalbuminemia as a risk factor for surgical site infection after oral cancer surgery

Cited by 58 publications

References 33 publications

Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery

Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery

Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion

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