PREOPERATIVE SERUM ALBUMIN LEVEL AS A PREDICTOR OF SURGICAL COMPLICATIONS AFTER EMERGENCY ABDOMINAL SURGERY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 30
Abstract
BACKGROUND Pre-operative nutritional status has been an important factor related to morbidity and mortality in surgical patients, of which hypoalbuminemia has been shown to have direct association with increased complication rates in surgical patients. Patients with serum albumin levels below 3 gm/dL show an independently associated increased risk of developing serious complications within 30 days of surgery. We wanted to analyse the association of preoperative serum albumin levels and surgical outcomes of emergency abdominal surgery. METHODS It is a prospective study involving 91 consecutive patients who underwent emergency abdominal surgeries in Government Medical College, Thrissur over a 6 months period. Albumin level of all patients was noted preoperatively as a part of preoperative workup. Postoperative complications were noted against 13 variables in a period of 30 postoperative days. RESULTS Albumin of the patients ranges from 0.9 to 4.3 gm/dL with mean= 3.085 and SD= 0.729. Total of 56 patients (61.6%) had hypoalbuminemia (serum albumin <3.5 gm/dL) at the time of operation. 73.6% of patients (n=67) developed at least one complication in the post-operative period. With serum albumin levels <2 gm /dL, 100% of patients developed complications in the post-operative period. With normal albumin levels (>3.5 gm/dL), only 51.4% (n=18) developed complications. Odds ratio 0.204 suggests that as albumin level decreases there is increased risk of postoperative complications and association is also statistically significant with a p value <0.001. As age of the patient increases complications are also increasing (odds ratio-1.026, p value < 0.041). CONCLUSIONS There is large and graded rise in mortality and morbidity as serum albumin level declined from high to low levels. Serum albumin is a good and simple predictor of surgical risk and has a close correlation with degree of malnutrition. Preoperative hypoalbuminemia (<3.5 gm/dL) is an independent risk factor for postoperative morbidity, mortality and increased hospital stay.
Authors and Affiliations
Vinodh Madhava Warrier, Abraham Niby Francis
Keywords
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- EP ID EP670356
- DOI 10.18410/jebmh/2019/408
- Views 84
- Downloads 0
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