Association of serum albumin with postoperative complication in major surgeries
DOI:
https://doi.org/10.18203/2349-2902.isj20212270Keywords:
Serum albumin, Nutritional assessment, Wound complication, Renal proceduresAbstract
Background: Nutritional assessment is essential for identifying patients who are at risk of developing complications related to significant malnutrition. Serum albumin is the most important laboratory test for the diagnosis of protein-calorie under nutrition.
Methods: A COHORT of 100 patients admitted for major elective surgery in the department of general surgery, Government medical college and hospital, Ambikapur, Sarguja, Chattisgarh, India. Patients who were admitted and undergoing any major elective surgeries having age above 12 years were included. Details of cases were recorded including demographic characteristics, history and clinical examination along with BMI and serum albumin.
Results: Complication rate was highest in the age group of 51-60 years (57.9%) followed by the age group of 41-50 years (53.8%). The association was found statistically significant between different level of serum albumin level and their post-operative wound complications. The highest complication rate was seen in patients with renal procedures like nephrectomy and pyelolithotomy (60.0%) but the most common type of procedure observed was bowel resection and anastomosis (38.7%).
Conclusions: The correlation between the serum albumin and complication rate was statistically significant in the malignant diseases when considered separately. Low serum albumin level can be used as a marker for nutritional deficiency and TPN as nutritional supplementation in certain subset of patients may reduce postoperatively septic wound complication.
References
MacFie J. Nutrition and Fluid Therapy. In: Williams N, O'Connell PR, eds. Bailey and Love’s Short Practice of Surgery. 25th ed. London: CRC Press; 2015:223.
Klingensmith ME. In: Wise PE, Courtney CM, Ohman KA, Schill MR, Yu J, eds. The Washington Manual of Surgery. 5th ed. New York: Lippincott Williams and Wilkins; 1991;325:52.
Klingensmith ME. In: Wise PE, Courtney CM, Ohman KA, Schill MR, Yu J, eds. The Washington Manual of Surgery. 5th ed. New York: Lippincott Williams and Wilkins; 1999:134-6.
Baron RB. Nutrition-assessment of nutritional status. In: current medical diagnosis and treatment. USA: McGraw Hill Medical; 2006:1263.
Banz MV, Jakob MS, Inderbitzin D. Improving outcome after major surgery: pathophysiological considerations. Anest Analg. 2011;112(5):1147-55.
Leite HP, Fisberg M, DeCarvallio WB. Serum albumin and clinical outcomes in paediatric cardiac surgery. Nutrition. 2005;21(5):553-8.
Golub R, Sorrento JJ, Cantu R, Nierman DM, Moideen A, Stein HD. Efficacy of albumin supplementation in the surgical intensive care unit: A prospective, randomized study. Crit Care Med. 1997;22(4):619-9.
Brown RO, Bradley JE, Bekemey WB, Luther RW. Effect of albumin supplementation during parenteral nutrition on hospital morbidity. Crit Care Med. 1988;16(12):1177-82.
Mullen JJ, Davenport DL, Hutter MM, Hosokawa PW, Henderson WG, Khuri SF, et al. Impact of BMI on perioperative outcome in patients undergoing major interabdominal cancer surgery. Ann Surg Onco. 2008;15(8):2164-72.
Kudsk KA, Tolley EA, Delvitt RC, Janu PG, Blackwell AP, Kin BK, et al. Preoperative albumin and surgical site identify surgical risk for major postoperative complications. JPEN J Parenter Enteral Nutr. 2003;27(1):1-9.
Liop JM, Munoz C, Badia MB, Virgili N, Tubau M, Ramon JM, et al. Serum albumin as an indicator clinical evaluation in patients on parenteral nutrition. Multivariate study. Clin Nutr. 2001;20(1):77-81.
Gibbs J, Cull W, Henderson W. Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity. Arch Surg. 1999;134(1):36-42.
Foley EF, Borlase BL, Dzik WH, Bistrian BR, Benotti PN. Albumin supplementation in the critically ill: a prospective, randomized trial. Arch Surg. 1990;125(6):739-42.
Beghetto MG, Luft VC, Mello ED, Polanczyk CA. Accuracy of nutritional assessment tools for predicting adverse hospital outcomes. Nutr Hosp. 2009;24(1):56-62.
