Preoperative Serum Albumin as an Independent Predictor of Post-Operative Morbidity
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 7, Issue 3
Abstract
Background: Approximately one-third to one-half of hospitalized patients are malnourished at the time of admission, and this nutritional status can not only adversely affect a patient’s clinical condition, but adversely affect their surgical outcomes as well. There are several tools to assess patient’s nutritional status. Among these, serum albumin is a good and simple predictor of surgical risk and has a close correlation with the degree of malnutrition. Hypoalbuminemia is associated with poor tissue healing, decreased collagen synthesisin the surgical wounds or at anastomotic sites, and also plays a role in the impairment of immune responses, such as macrophage activation and granuloma formation. Hence, in hypoalbuminemic patients, wound infection, remote infections such as pneumonia, and anastomotic leaks are seen commonly. Although it is well established that hypoalbuminemia, as a marker of malnutrition and disease, is associated with greater risk of adverse surgical outcome, previous studies have been based on relatively small samples and selected types of operations and have failed to adequately separate the predictive ability of albumin level from other risk factors. Methods and Material: This is a prospective study conducted from October 2014 to October 2016 in Yenepoya Medical College Hospital, Mangalore. 100 patients undergoing clean and clean contaminated surgery with a preoperative albumin level below 3.5 mg/dl were included in the study. Post-operative parameters were observed in these patients. Results: 100 patients were included in the study. 53 % of our patients were male and 47% female with ages ranging from 18 to 72 years (mean – 48.18). The mean preoperative albumin was 3.038 g/dl. 60% of patients developed complications postoperatively. 34% suffered from a surgical site infection, and among other complications paralytic ileus and seromas (12% each) were commonest. After analysis, we found a significantly higher risk of SSIs and complications in patients with preoperative hypoalbuminemia and a negative correlation of albumin levels with length of hospital stay and resumption of oral diet. Conclusions: Preoperative albumin can be used as a predictor of surgical outcome in clean and clean contaminated cases.
Authors and Affiliations
Vijeth Rai, Harshavardhan M N, Harishchandra B
Keywords
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