Role of pre-operative serum albumin level in predicting the  post-operative outcomes in gastrointestinal surgery

Background: The prevalence of protein-energy malnutrition in surgical patients is seen in 30-50% of surgical patients with gastrointestinal disease. Malnutrition and hypalbuminaemia contribute to increased morbidity and mortality. Serum albumin level is a low-cost key element in nutritional assessment. Clavien-Dindo classification of post-operative complications enables stratification of post-operative complication.Methods: We retrospectively analysed the prospectively maintained data of 136 patients who underwent major gastro intestinal procedures from October 2019 to March 2020. We assessed the pre-operative; intra operative parameters, outcome variables and the postoperative complications were graded according to Clavien-Dindo severity, length of ICU stay, length of hospitalization and mortality.Results: Out of the 136 patients (M: F=3:2), the procedures were hepatopancreaticobiliary (n=40), colorectal (n=39), small bowel (n=36) and esophago-gastric (n=19). Pre-operative serum albumin was identified to be single most statistically significant pre-operative variable predicting post-operative complication of Clavien-Dindo severity grade III and above. The ROC curve of the serum albumin level predicting the severe post-operative complication suggested optimal cut off value of 3.1 gm/dl (AUC=0.76; 5% CI=0.64-0.87; p<0.001). Linear regression analysis of serum albumin level predicting the severe post-operative complication suggested good correlation with (r2=0.133; b=0.689; p<0.001). Further analysis of serum albumin level in predicting the length of ICU and the hospital stays suggested a significant negative correlation with both of these dependent outcome variables. The serum albumin level correlated inversely with the length of ICU stay and hospitalization.Conclusions: Low pre-operative albumin (serum level <3.1 gm/dl) in patients undergoing major gastrointestinal surgery predicts severe post-operative complications, prolonged ICU and hospital stays.

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Correlation of Serum Albumin Level to Lung Ultrasound Score and Its Role as Predictors of Outcome in Acute Respiratory Distress Syndrome Patients: A Prospective Observational Study

Critical Care Research and Practice ◽

10.1155/2021/4594790 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Souvik Chaudhuri ◽

Sagar S. Maddani ◽

Shwethapriya Rao ◽

Sirish Gauni ◽

N. R. Arjun ◽

...

Keyword(s):

Serum Albumin ◽

Prospective Observational Study ◽

Distress Syndrome ◽

Serum Albumin Level ◽

Lung Ultrasound ◽

Albumin Level ◽

Prolonged Length ◽

Icu Stay ◽

Ultrasound Score ◽

Length Of Icu Stay

Background. There is ambiguity in the literature regarding hypoalbuminemia as a cause of extravascular lung water and acute respiratory distress syndrome (ARDS) outcomes. The aim of the study was to determine if low serum albumin on admission leads to lung deaeration and higher lung ultrasound score (LUSS) in ARDS patients. Patients and Methods. It was a prospective observational study in which 110 ARDS patients aged between 18 and 70 years were recruited. Serum albumin level and lung ultrasound score were assessed on the day of ICU admission. Length of ICU stay and hospital mortality were recorded. Results. The mean and standard deviation of serum albumin level in mild, moderate, and severe ARDS was 2.92 ± 0.65 g/dL, 2.91 ± 0.77 g/dL, and 3.21 ± 0.85 g/dL, respectively. Albumin level was not correlated to the global LUSS (Pearson correlation r −0.006, p = 0.949 ) and basal LUSS (r −0.066, p = 0.513 ). The cut-off value of albumin for predicting a prolonged length of ICU stay (≥10 days) in ARDS patients was <3.25 g/dL with AUC 0.623, p < 0.05 , sensitivity of 86.67%, specificity of 45.45%, and 95% confidence interval (CI) [0.513–0.732], and on multivariate analysis it increased the odds of prolonged ICU stay by 8.9 times (Hosmer and Lemeshow p value 0.810, 95% CI [2.760–28.72]). Serum albumin at admission was not a predictor of mortality. LUSS on the day of admission was not useful to predict either a prolonged length of ICU stay or mortality. Basal LUSS contributed about 56% of the global LUSS in mild and moderate ARDS, and 53% in severe ARDS. Conclusion. Serum albumin level was unrelated to LUSS on admission in ARDS patients. Albumin level <3.25 g/dL increased the chances of a prolonged length of ICU stay (≥10 days) but was not associated with an increase in mortality. LUSS on the day of admission could not predict either a prolonged length of ICU stay or mortality. This trial is registered with CTRI/2019/11/021857.

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Serum albumin level can predict disease progression in patients with HIV infection

PsycEXTRA Dataset ◽

10.1037/e556822006-018 ◽

2000 ◽

Keyword(s):

Hiv Infection ◽

Serum Albumin ◽

Disease Progression ◽

Serum Albumin Level ◽

Albumin Level ◽

Predict Disease Progression

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Faculty Opinions recommendation of Serum albumin level as a predictor of outcome in traumatic brain injury: potential for treatment.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1108329.564361 ◽

2008 ◽

Author(s):

John Myburgh

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Serum Albumin ◽

Serum Albumin Level ◽

Albumin Level ◽

Injury Potential

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Low Serum Albumin Level is Risk Factor for Patients with Percutaneous Endoscopic Gastrostomy

Internal Medicine ◽

10.2169/internalmedicine.49.3057 ◽

2010 ◽

Vol 49 (21) ◽

pp. 2283-2288 ◽

Cited By ~ 17

Author(s):

Naoyuki Tominaga ◽

Ryo Shimoda ◽

Ryuichi Iwakiri ◽

Nanae Tsuruoka ◽

Yasuhisa Sakata ◽

...

Keyword(s):

Risk Factor ◽

Serum Albumin ◽

Percutaneous Endoscopic Gastrostomy ◽

Serum Albumin Level ◽

Albumin Level ◽

Endoscopic Gastrostomy ◽

Low Serum

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TONGUE APPEARANCE AND SERUM ALBUMIN LEVEL IN THE ASSESSMENT OF NUTRITIONAL STATUS, WITH REFERENCE TO THE EFFECTS OF A PROTEINRICH DIET

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1955.tb37777.x ◽

1955 ◽

Vol 1 (10) ◽

pp. 344-346 ◽

Cited By ~ 3

Author(s):

Bryan Gandevia ◽

D. Hossack

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Serum Albumin Level ◽

Albumin Level

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Serum albumin level accurately reflects antioxidant potentials in idiopathic nephrotic syndrome

Clinical and Experimental Nephrology ◽

10.1007/s10157-011-0578-y ◽

2011 ◽

Vol 16 (3) ◽

pp. 411-414 ◽

Cited By ~ 8

Author(s):

Kazunari Kaneko ◽

Takahisa Kimata ◽

Shoji Tsuji ◽

Tomohiko Shimo ◽

Masaya Takahashi ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Serum Albumin ◽

Serum Albumin Level ◽

Idiopathic Nephrotic Syndrome ◽

Albumin Level

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Association of preoperative hypoalbuminemia with postoperative acute kidney injury in patients undergoing brain tumor surgery: a retrospective study

Journal of Neurosurgery ◽

10.3171/2016.11.jns162237 ◽

2018 ◽

Vol 128 (4) ◽

pp. 1115-1122 ◽

Cited By ~ 6

Author(s):

Kyungmi Kim ◽

Ji-Yeon Bang ◽

Seon-Ok Kim ◽

Saegyeol Kim ◽

Joung Uk Kim ◽

...

Keyword(s):

Acute Kidney Injury ◽

Brain Tumor ◽

Serum Albumin ◽

Serum Albumin Level ◽

Kidney Injury ◽

Albumin Level ◽

Tumor Surgery ◽

Brain Tumor Surgery ◽

Preoperative Serum ◽

Postoperative Aki

OBJECTIVEHypoalbuminemia is known to be independently associated with postoperative acute kidney injury (AKI). However, little is known about the association between the preoperative serum albumin level and postoperative AKI in patients undergoing brain tumor surgery. The authors investigated the incidence of AKI, impact of preoperative serum albumin level on postoperative AKI, and death in patients undergoing brain tumor surgery.METHODSThe authors retrospectively reviewed the electronic medical records and laboratory results of 2363 patients who underwent brain tumor surgery between January 2008 and December 2014. Postoperative AKI was defined according to Kidney Disease: Improving Global Outcomes Definition and Staging (KDIGO). Multivariate logistic regression analysis was used to identify demographic, preoperative laboratory, and intraoperative factors associated with AKI development. Cox proportional hazards models were used to investigate the adjusted odds ratio and hazard ratio for the association between preoperative serum albumin level and outcome variables.RESULTSThe incidence of AKI was 1.8% (n = 43) using KDIGO criteria. The incidence of AKI was higher in patients with a preoperative serum albumin level < 3.8 g/dl (3.5%) than in those with a preoperative serum albumin level ≥ 3.8 g/dl (1.2%, p < 0.001). The overall mortality was also higher in the former than in the latter group (5.0% vs 1.8%, p < 0.001). After inverse probability of treatment-weighting adjustment, a preoperative serum albumin level < 3.8 g/dl was also found to be associated with postoperative AKI (OR 1.981, 95% CI 1.022–3.841; p = 0.043) and death (HR 2.726, 95% CI 1.522–4.880; p = 0.001).CONCLUSIONSThe authors’ results demonstrated that a preoperative serum albumin level of < 3.8 g/dl was independently associated with AKI and mortality in patients undergoing brain tumor surgery.

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