Preoperative serum albumin level as a predictor of perioperative outcome in patient undergoing major gastrointestinal surgery

Abstract

Introduction: Hypoalbuminemia, as a marker of malnutrition and disease, is associated with higher risk of poor postoperative outcomes. However, no study has been reported from our country until now. Our aim was to identify the relationship between preoperative hypoalbuminemia and the development of complications after major gastrointestinal surgery.
 Methods: A prospective study of 106 patients who underwent major elective gastrointestinal surgery between July 2012 to June 2013 in Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal were considered for the study. Serum albumin was determined preoperatively in all patients. Hypoalbuminemia was defined as albumin less than 35 mg/dl. Thirty-day postoperative complications were analyzed.
 Results: The patients were 70 males (66 %) and 36 females (34%) with a mean age of 50 years (23-81). Thirty-six patients (34%) had hypoalbuminemia. Overall complication rate was 32%. Hypoalbuminemic patients had a significantly higher rate of postoperative complications (26.4 and 5.6%; P<0.05). In multivariate analysis, age (>50 year), BMI (<18 kg/m2), duration of surgery (>3 hours) and hypoalbuminemia (<35 mg/dl) were the significant risk factors for postoperative complications (P<0.05).
 Conclusion: Preoperative hypoalbuminemia is an independent predictor of postoperative outcomes in patients with elective major gastrointestinal surgery. Identification and optimization of nutritional status prior to surgery may improve surgical outcomes.

Preoperative Serum Albumin Level as a Predictor of Abdominal Wound-Related Complications After Emergency Exploratory Laparotomy

“…Similar results were reported in a previous study by Sharath Kumar et al [ 13 ], in which 61.5% were males and 38.5% were females. In another study by Bhandari et al [ 11 ], 66% were males and 34% were females. Males were more commonly involved in road traffic accidents compared to females because males are at high risk while traveling compared to females who mostly stay at home in a developing country like India.…”

“…However, in contrast to our study, in the study by Gibbs et al [ 12 ], the median age was 61 years. In another study by Bhandari et al [ 11 ], the median age was 50 years. The patients included in our study were mostly in the age group of 21-30 years, which could be due to the exclusion of comorbidities such as hypertension, diabetes mellitus, liver disease, and kidney disease which are common in the elderly age group.…”

“…Serum albumin level <3.5 g/dL in a stable and well-hydrated patient suggests malnutrition [ 10 ]. Further, previous studies suggested that preoperative serum albumin is a good predictor of surgical outcomes in elective gastrointestinal surgeries as well as many other surgeries except cardiac surgeries [ 11 , 12 ].…”

Psoas Muscle Index Defined by Computer Tomography Predicts the Presence of Postoperative Complications in Colorectal Cancer Surgery

“…The other powerful prognostic factor is the level of albuminemia as a marker of nutritional status. Some of the authors suggest the correction of the albumin level before surgery [ 21 ], this also proved to be significant in the occurrence of complications [ 22 ].…”