Preoperative serum albumin level as independent predictor of surgical outcome in acute abdomen

Kanakeswar Bhuyan, Smita Das


Background: The prognostic implications and significance of hypoalbuminemia after surgical intervention is significant. In this study, we assess the predictive value of preoperative serum albumin level on postoperative morbidity and mortality following surgical intervention in acute abdomen.

Methods: In this retrospective study, Medical records of 110 patients with estimated preoperative serum albumin level undergoing exploratory laparotomy with acute abdominal conditions in a tertiary health care centre were reviewed. Patients with record of preoperative serum albumin level were reviewed. Albumin less than 3.2 g/dL was recognized as hypoalbuminemia. Types of surgery, postoperative complications, and mortality rates were collected. The association between preoperative serum albumin level and postoperative morbidity and mortality was assessed.

Results: Preoperative serum albumin level of 3.2g/dl was found in 33 (30%) cases and 77 (70%) patients had same or less than 3.2g/dl albumin. Patients with preoperative serum albumin less than 3.2 g/dL had complications in 50 (45.5%) cases than that of normal preoperative albumin levels (07: 5.5%; p=<0.0001, 95% CI=0.119-0.528). There was total mortality of 15 (14%). High Mortality of 14 (18%) patients was found in patients with low albumin group. There was 3% mortality with normal serum albumin level (P=<0.362; 95% CI=0.029-1.34). Skin and soft tissue infections were found in 5 (15%) cases with albumin >3.2g/dl and 28 cases with less than 3.2g/dl (p=<0.397; 95%CI= 0.17-0.98). Chest infections were found in 2 cases (6%) with >3.2g/dl serum albumin against 20 cases (25%) with less than 3.2g/dl. (p=0.0187; 95% CI=0.066-0.997).

Conclusions: Preoperative hypoalbuminemia is an independent risk factor for postoperative complications after emergency laparotomy.    


Serum albumin, Surgery, Morbidity, Mortality

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