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 de?ned 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.
Keywords: Gastrointestinal Surgery; Hypoalbuminemia; Postoperative Complication