Role of serum albumin and body mass index as predictors of post-operative morbidity and mortality in elective major abdominal surgeries

Bhagvat, Vikrant M.; Ghetla, Smruti; Shetty, Tilakdas; Upwanshi, Manish

doi:10.18203/2349-2902.isj20163973

Cited by 9 publications

(11 citation statements)

References 6 publications

(6 reference statements)

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“…Patients with low albumin had more number of complications as compared to patients with normal complications. This study is concordant with the study conducted by Bhagvat VN et al 9 Out of the various complications, wound infection was the most common complication. 26% patient had wound infection because of low albumin.…”

Section: Discussionsupporting

confidence: 92%

Serum albumin as predictor of post-operative morbidity and mortality

Sharma¹,

Purohit²,

Pipal³

et al. 2017

Int Surg J

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INTRODUCTIONThe prevalence of protein energy malnutrition in surgical patients is high ranging from 10 to 54%. The correct assessment of the nutritional status is crucial since malnourishment is a risk factor for morbidity and mortality.1 Identification of patients with high risk is essential in operative indications and decisions often limited by potential morbidities and mortality related to the procedure. Hence, the clinical and laboratory parameters which may point out higher risk for postoperative complications are important. 2Malnourishment is reported in 40 -50% of hospitalized patients with higher risk factor for postoperative infections and healing complication in patients who undergo surgeries.3 Protein-energy malnutrition affects every organ system. The most obvious results are loss of body weight, adipose tissue and skeletal muscle mass and due to changes in immunological status poor wound healing occurs. 4A dietary history and physical examination (including anthropometric measurements) with relevant laboratory tests are appropriate tools needed for an accurate evaluation of a patient's pre-operative nutritional status. Serum albumin is most readily available parameter.Albumin is a protein synthesized by liver with a long mean life (21 days), hence, variations in its concentration during a short interval can't be explained by nutrition or liver function alteration. 5 Some studies showed that serum albumin lower than 3 gm/dl was followed by anergia as well as by more frequent and severe postoperative ABSTRACT Background: Protein energy malnutrition affects every organ system. So correct assessment of nutritional status is important as malnourishment is a risk factor for morbidity and morality in surgical patients. In our study, serum albumin has been taken as parameter for nutritional assessment. Methods: Study is conducted on 50 patients admitted in Department of General Surgery, Dr. Sampurnanand Medical College and associated Hospital, Jodhpur, Rajasthan, India for surgeries during January 2014-December 2015. Data was analyzed using Z-test and Fischer exact t-test and p value was calculated. P value <0.05 is considered statistically significant. Results: Patients with serum albumin <3gm/dl had more complications with maximum number of complications in age group of 41-60 year group. This finding was statistically significant. Conclusions: Low serum albumin patients has more post-operative complication than those with normal level and so is a good indicator of post-operative morbidity and mortality.

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Section: Discussionsupporting

confidence: 92%

Serum albumin as predictor of post-operative morbidity and mortality

Sharma¹,

Purohit²,

Pipal³

et al. 2017

Int Surg J

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“…The mean age group in this study group is 45.7 years. The highest percentage of patients were in the age group 41-50 years comprising of 27% compared to study conducted by Vikrant M Bhagavat et al [6] on role of serum albumin and BMI as predictors of post operative morbidity and mortality in major abdominal surgeries where the highest percentage of patients were in the age group 51-60 comprising of 35%.…”

Section: Age Comparisonmentioning

confidence: 67%

“…In this study group of 100 patients percentage of patients >3.5 gm/dl is 72% and 26% patients had serum albumin levels of 3.5 -2.8gm/dl and 2% patients with <2.8gm/dl compared to 38% with >3.5 gm/dl and 62% with serum albumin <3.5 gm/dl In a study conducted by Vikrant M Bhagavat et al [6] on role of serum albumin and BMI as predictors of post operative morbidity and mortality in major abdominal surgeries. In study conducted by Amir Akirov et al [8] 65% patients had serum albumin level >3.5gm/dl, 29% patients had serum albumin level in between 2.5 -3.5 gm/dl and 5% patients with serum albumin level 2.5gm/dl and below.…”

Section: Serum Albumin Comparisonmentioning

confidence: 67%

“…In the study done by Peri chum chao et al [5] on MUST and a nutritional education programe for high risk cancer patients which comprised of 74.5% males and 25.5% females. A study conducted by Vikrant M Bhagavat et al [6] on role of serum albumin and BMI as predictors of post operative morbidity and mortality in major abdominal surgeries comprised of 54% males and 46% females. A study conducted by Xuanhui Liu et al [7] on role of preoperative hypoalbuminemia association with an increased risk of intra abdominal septic complications after anastomosis in crohn's patients comprised of 79% males and 21% females.…”

Section: Sex Distribution Comparisonmentioning

confidence: 99%

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A study on role of preoperative nutritional status on post operative outcome in general surgical patients

Reddy¹,

Chaithanya²

2020

Int. J. Surg. Sci.

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Pre-operative nutritional status in patients scheduled for elective or emergency surgery by measuring the MUST score and serum albumin, has influence on the post-operative outcome and recovery. Aims: To find the predictability of MUST and Serum albumin on hospital stay, post op complication like seroma, SSI, wound dehiscence and mortality Settings and Design: This is a prospective and observational study conducted in Narayana medical college and hospital between January 2017 and October 2018. Methods and Material: 100 patients were included. Pre operatively assessed for their nutritional status using MUST and serum albumin. They are categorised into low, moderate and high-risk categories in both MUST and Sr. albumin Statistical analysis used: Chi-square test, student's t-test, Pearson's correlation Results: Mean age group of presentation was 45.72 years. 69% were male 31% were female. Elective surgeries were 80% and emergency surgeries were 20%. Seroma developed in 33.3% of medium risk, 9.8% in low risk group. SSI developed in 23.5% of high-risk group, 5.6% in low risk group. Wound dehiscence developed in 11.7% of high-risk, 2.8% in low risk group. The mean post-operative hospital stay was 8.24 days in high risk group, 7.67 in medium risk and 7.8 in low risk group according to MUST score. Mean Post-operative hospital stay was 11.5 days in high risk 9.46 days in medium risk 7.18 days in low risk group as per serum albumin categorization. Conclusions: MUST was reliable in predicting post-op complications and serum albumin was reliable in predicting post-op hospital stay.

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“…In a similar study conducted by Bhagvat et al found that number of patients were highest (34%) in the age group 31-40 years, and the highest number of complications was noted in the age group of 51-60 years. 5 However, Kumar et al, found that the highest number of patients belonged to the age group 51-60 years of age and the maximum number of complications were also found in the same group. 6…”

Section: Discussionmentioning

confidence: 96%

Role of serum albumin and body mass index in the outcome of major elective abdominal surgery

et al. 2019

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Background: The prevalence of protein-energy malnutrition in surgical patients is high, ranging from 10% to 54%. The correct assessment of the nutritional studies of such patients is crucial since malnutrition is a risk factor for morbidity and mortality. There is a substantial evidence to show that patients who have signs of malnutrition have a higher risk of complications and an increased risk of death in comparison with patients who have adequate nutritional reserves.Methods: 150 patients were selected for the study. All the collected data was entered in Microsoft Excel sheet. It was then transferred to SPSS ver. 21 software for statistical analysis. Quantitative data was compared by using student’s t-test and chi-square test, qualitative data compared using frequency, standard deviation and percentage. P<0.05 considered as significant.Results: The mean serum albumin was found to be 3.7 gm%±0.3. There was increase rate of complication and duration of hospital stay in those patients with serum albumin <3.5 gm% and BMI>25 kg/m2 and wound infection was found to be the most common complication among these patients.Conclusions: Majority of patients had serum albumin >3.5 gm/dl and more complications were seen with serum albumin <3.5 gm/dl which was statistically significant (p=0.01). Serum albumin is a good prognostic indicator because of its ability to detect protein energy malnutrition.

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Role of serum albumin and body mass index as predictors of post-operative morbidity and mortality in elective major abdominal surgeries

Cited by 9 publications

References 6 publications

Serum albumin as predictor of post-operative morbidity and mortality

Serum albumin as predictor of post-operative morbidity and mortality

A study on role of preoperative nutritional status on post operative outcome in general surgical patients

Role of serum albumin and body mass index in the outcome of major elective abdominal surgery

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