scholarly journals Preoperative Serum Albumin Level As A Predictor Of Postoperative Pneumonia After Femoral Neck Fracture Surgery In A Geriatric Population

2019 ◽  
Vol Volume 14 ◽  
pp. 2007-2016 ◽  
Author(s):  
Yakang Wang ◽  
Xiaoli Li ◽  
Yahong Ji ◽  
Hua Tian ◽  
Xiaofang Liang ◽  
...  
2016 ◽  
Vol 98 (6) ◽  
pp. 376-379 ◽  
Author(s):  
O Riaz ◽  
R Arshad ◽  
S Nisar ◽  
R Vanker

Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%–19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60–101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seong-Eun Byun ◽  
Kyeu Back Kwon ◽  
Sang Ho Kim ◽  
Seung-Jae Lim

Abstract Background Dysphagia is prevalent in geriatric patients, such as elderly hip fracture patients, and is associated with a poor prognosis. This study investigated (1) the prevalence of dysphagia based on clinical screening and a video-fluoroscopic swallowing study (VFSS), (2) the risk factors of dysphagia, and (3) the prognostic implications of dysphagia in elderly patients (≥ 65 years) undergoing hip fracture surgery. Methods In this retrospective study, data from 393 female and 153 male patients ≥65 years of age who underwent surgery for a hip fracture between 2015 and 2018 were analysed. Patients who were considered at high risk of dysphagia after screening underwent a VFSS. To identify risk factors of dysphagia, demographic factors, the American Society of Anesthesiologists classification, past medical history, known risk factors of dysphagia, and factors associated with surgery were analysed using a binary logistic regression model. Odds ratios (ORs) of dysphagia for having poor prognosis including postoperative pneumonia, intensive care unit (ICU) admission, and death within 6 months after surgery were obtained by logistic regression. The association of postoperative pneumonia with poor prognosis was also analysed. Results Dysphagia was seen in 5.3% of hip fracture patients. In multivariate regression analysis, a serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia (OR [95%CI] = 3.13 [1.40, 7.01]). Dysphagia was identified as a risk factor for postoperative pneumonia in regression analysis after adjustment (OR [95%CI] = 3.12 [1.05, 9.27]). Postoperative pneumonia was significantly associated with ICU admission (OR [95% CI] = 4.56 [1.85, 11.28]) and death within 6 months after surgery (OR [95% CI] = 2.56 [1.03, 6.33]). Conclusions Dysphagia in elderly hip fracture surgery patients was associated with postoperative pneumonia, a risk factor for poor outcomes including ICU admission and death within 6 months after surgery. A serum albumin level < 3.5 g/dL was identified as a risk factor for dysphagia. Therefore, diagnostic testing should be performed to detect dysphagia, especially in patients with a low serum albumin level. Finally, particular care should be taken to prevent postoperative complications in patients with dysphagia.


2018 ◽  
Vol 128 (4) ◽  
pp. 1115-1122 ◽  
Author(s):  
Kyungmi Kim ◽  
Ji-Yeon Bang ◽  
Seon-Ok Kim ◽  
Saegyeol Kim ◽  
Joung Uk Kim ◽  
...  

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.


2016 ◽  
Vol 23 (8) ◽  
pp. 2411-2418 ◽  
Author(s):  
Yeqian Huang ◽  
Nayef A. Alzahrani ◽  
Terence C. Chua ◽  
Ya Ruth Huo ◽  
Winston Liauw ◽  
...  

2018 ◽  
Vol 38 (4) ◽  
Author(s):  
Jing Liu ◽  
Fang Wang ◽  
Shaohong Li ◽  
Wenhui Huang ◽  
Yanjuan Jia ◽  
...  

Preoperative serum albumin has been considered to be closely correlated with the prognosis of various cancers, including urothelial carcinoma (UC). However, to date, this conclusion remains controversial. The aim of this meta-analysis is to investigate the prognostic significance of preoperative serum albumin in UC. A literature search was performed in PubMed, Web of Science, Embase, and Cochrane Library up to 4 July 2017. Herein, a total of 15506 patients from 23 studies were enrolled in our meta-analysis. Decreased preoperative serum albumin level predicted poor overall survival (OS) (HR = 1.88, 95% CI: 1.44–2.45, P<0.0001), cancer-specific survival (CSS) (HR = 2.03, 95% CI: 1.42–2.90, P=0.0001), recurrence-free survival (HR = 1.85, 95% CI: 1.15–2.97, P=0.01), 30-day complications (30dCs) after surgery (odds ratio (OR) = 1.93, 95% CI: 1.16–3.20, P=0.01), and 90-day mortality after surgery (OR = 4.24, 95% CI: 2.20–8.16, P<0.001). The subgroup analyses indicated that low preoperative serum albumin level is still positively associated with a worse prognosis of UC based on ethnicity, cut-off value, tumor type, analyses type, and sample size. Our meta-analysis indicated that reduced preoperative serum albumin level was a predictor of poor prognosis of UC.


2019 ◽  
Vol 6 (2) ◽  
pp. 361
Author(s):  
Sharath Kumar V. ◽  
Dhruva G. Prakash ◽  
Venkatasiva Krishna Pottendla

Background: Hypoalbumenia has been shown to be associated with increased morbidity and mortality in acute surgical patients due to increased catabolism. This study intends to correlate between hypoalbumenia and postoperative complications in patients undergoing emergency abdominal surgery.Methods: A prospective study is done in a rural tertiary care centre in a total of 190 patients undergoing emergency abdominal surgery after obtaining ethical clearance. In this study preoperative serum albumin and postoperative complications including death up to postoperative day thirty were recorded and gathered using a checklist designed for the study and analysed. Serum albumin less than 3.5g/dl is considered as hypoalbumenia in this study. The correlation between preoperative serum albumin and postoperative morbidity and mortality is assessed.Results: In a total of 190 patients, 93 (48.9%) patients had morbidity and 27 (14.2%) patients had mortality. Preoperative serum albumin less than 3.5g/dl is found in 120 (63.1%) cases and 70 (36.9%) patients has same or more than 3.5g/dl. Patients with preoperative serum albumin less than 3.5g/dl has morbidity in 87 (45.8%) patients than that of normal preoperative serum albumin level which is 6 (3.1%) cases (p= <0.0001, chi-square =72.31). The total mortality is 27 (14.2%) in which all mortality is found in low albumin group compared to no mortality in patients with normal serum albumin. As the albumin level decreases the risk of morbidity and mortality increases with majority of complication in this study occurring in patients with albumin group less than 2.5g/dl to 3g/dl.Conclusions: Preoperative serum albumin is a good predictor of surgical outcome after emergency abdominal surgery.


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