E-ISSN 2367-699X | ISSN 2367-7414
 

Original Research

Online Publishing Date:
26 / 03 / 2023

 


The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study

Bharath Kumar Bhat, Praveen K N, Suresh Kumar Singhvi.


Abstract
Introduction:
The prevalence of malnutrition is 30-50% in the hospital inpatients. Serum albumin level is an easily available indicator of preoperative nutritional status. The pre-operative hypoalbuminemia predisposes to post-operative morbidity and mortality. The post-operative complication grading system following major gastrointestinal surgery by Clavien- Dindo enables objective assessment of the severity.
Aim:
To study the role of preoperative serum albumin as a predictor of severe post-operative complications after major gastrointestinal surgery.
Materials and methods:
It is a prospective observational study conducted from October 2016 to April 2018 in a tertiary care center of northern India. All patients undergoing the major gastrointestinal surgery after exclusion of those with a predefined criteria constitute the study population. The pre –operative serum albumin level was determined. Patients were categorized according to the serum albumin level after calculating the cutoff from the data collected. The outcome variables like severity of post-operative complications, duration of ICU, length of hospitalization and mortality were analyzed.
Results:
We have studied 100 patients of which 65 (65%) were males and 35 (35%) were females. Twenty two (22%) patients developed severe (Clavien-Dindo Grade ≥ 3) post-operative complications. The preoperative albumin level, intraoperative blood loss and the need for the blood transfusion was found to be the significant predictor of sever post-operative complications. The cut off value of pre-operative albumin level for the prediction of severe post operative complications was calculated to be 3.1 gm/dL (95% CI 0.64- 0.87; p value less than 0.001). The correlation between pre-operative albumin level and post-operative complication severity on simple linear regression analysis was found to be statistically significant with R2=0.133 and co-efficient of -0.689 (p<0.001). Statististically significant correlation between preoperative serum albumin and duration of ICU, length of hospitalisation was identified. The cut off serum albumin level for postoperative mortality was 3.5gm/dl (AUC= 0.7) which was statistically insignificant (p=0.104).
Conclusion:
Pre-operative hypoalbuminemia with the level less than 3.1gm/dL can predict higher grades of complications, increased length of hospitalization and ICU stay after major gastrointestinal surgeries.

Key words: Malnutrition, Pre-operative hypoalbuminemia, postoperative morbidity, Major Gastrointestinal Surgery, serum albumin level, post-operative complication


 
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How to Cite this Article
Pubmed Style

Bhat BK, N PK, Singhvi SK. The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study. Int J Surg Med. 2023; 9(2): 23-29. doi:10.5455/ijsm.136-1662907465


Web Style

Bhat BK, N PK, Singhvi SK. The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study. https://www.ejos.org/?mno=113329 [Access: July 18, 2024]. doi:10.5455/ijsm.136-1662907465


AMA (American Medical Association) Style

Bhat BK, N PK, Singhvi SK. The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study. Int J Surg Med. 2023; 9(2): 23-29. doi:10.5455/ijsm.136-1662907465



Vancouver/ICMJE Style

Bhat BK, N PK, Singhvi SK. The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study. Int J Surg Med. (2023), [cited July 18, 2024]; 9(2): 23-29. doi:10.5455/ijsm.136-1662907465



Harvard Style

Bhat, B. K., N, . P. K. & Singhvi, . S. K. (2023) The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study. Int J Surg Med, 9 (2), 23-29. doi:10.5455/ijsm.136-1662907465



Turabian Style

Bhat, Bharath Kumar, Praveen K N, and Suresh Kumar Singhvi. 2023. The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study. International Journal of Surgery and Medicine, 9 (2), 23-29. doi:10.5455/ijsm.136-1662907465



Chicago Style

Bhat, Bharath Kumar, Praveen K N, and Suresh Kumar Singhvi. "The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study." International Journal of Surgery and Medicine 9 (2023), 23-29. doi:10.5455/ijsm.136-1662907465



MLA (The Modern Language Association) Style

Bhat, Bharath Kumar, Praveen K N, and Suresh Kumar Singhvi. "The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study." International Journal of Surgery and Medicine 9.2 (2023), 23-29. Print. doi:10.5455/ijsm.136-1662907465



APA (American Psychological Association) Style

Bhat, B. K., N, . P. K. & Singhvi, . S. K. (2023) The role of pre-operative serum albumin level in predicting the severe post-operative complications of major gastrointestinal surgery: A Prospective observational study. International Journal of Surgery and Medicine, 9 (2), 23-29. doi:10.5455/ijsm.136-1662907465