Preoperative serum albumin as predictor of adverse outcome in emergency abdominal surgery

Jishan Ahmed, Nayan M. Sarma


Background: Serum albumin is a useful indicator of protein energy malnutrition, which may and may not be clinically apparent, but is linked to a significantly higher risk of morbidity and mortality. In this study, we assess the post-operative morbidity with relation to pre-operative albumin status, in patients undergoing emergency abdominal surgery.

Methods: In this hospital based observational study, 96 patients undergoing emergency abdominal surgery at Assam Medical College and Hospital were included. Hypoalbuminemia was diagnosed if serum albumin level was less than 3.5 gm/dl. Types of surgery and postoperative complications were included in the study. Any association between preoperative serum albumin level and postoperative morbidity was assessed. Study period was between May 2020 to May 2021.

Results: Pre-operatively, 56 patients had hypoalbuminemia (serum albumin <3.5 g/dl) and 40 patients had normal albumin levels (≥3.5 g/dl). Out of 96 patients, 32 (33.3%) developed complications postoperatively. 25 patients (44.6%) out of 56 patients with hypoalbuminemia (with serum albumin <3.5 g/dl) had complications. 7 patients (17.5%) with albumin level ≥3.5 g/dl had complications. Surgical site infection was found in 7 (17.5%) cases with albumin >3.5 g/dl and 21 (37.5%) cases with less than 3.5 g/dl (p≤0.033). Wound dehiscence was found in 1 (2.5%) case with >3.5 g/dl serum albumin against 9 (16.1%) cases with less than 3.5 g/dl (p≤0.031). Mean length of hospital stay was found to be higher i.e. 9.73±4.85 days in patients with hypoalbuminemia, compared to 6.45±3.31 days with those having albumin level ≥3.5 g/dl.

Conclusions: Preoperative albumin is a useful low-cost prognostic predictor for predicting surgery outcome.


Serum albumin, Emergency surgery, Morbidity

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