IP187. Poor Nutritional Status Before Peripheral Artery Bypass Surgery Is an Independent Predictor of Postoperative Mortality

Abstract

Preoperative nutritional status is increasingly being considered a predictor for postoperative complications. Preoperative albumin concentration has been shown to have an impact on the surgical outcomes for several surgical operations. This study evaluated the effect of preoperative albumin concentration on postoperative outcomes after lower extremity bypass surgery. The American College of Surgeons National Surgical Quality Improvement Program database for 2015 was used for this study. All patients who underwent lower extremity bypass surgery were divided into two groups (preoperative albumin levels <3.5 g/dL vs albumin levels >3.5 g/dL). Preoperative, intraoperative, and postoperative factors were compared between these groups using bivariate logistic regression analysis. Multivariate logistic regression analysis was then conducted of variables that were independently associated with low preoperative albumin levels. A total of 1399 patients (33% female, 67% male) were identified. Mean age was 67.5 years. Multivariate analysis showed the following preoperative factors to be present in patients with low (<3.5 g/dL) albumin levels: dialysis dependent (odds ratio [OR], 0.3; confidence interval [CI], 0.1-0.6; P < .05), chronic obstructive pulmonary disease (OR, 0.6; CI, 0.4-0.9; P < .05), diabetes (OR, 1.5; CI, 1.2-1.8; P < .05), and congestive heart failure (OR, 2.8; CI, 1.5-5.4; P < .05). The following postoperative complications were associated with poor serum albumin levels: death (OR, 0.2; CI, 0.1-0.6; P < .05), extended length of hospital stay (OR, 0.6; CI, 0.5-0.8; P < .05), and postoperative pneumonia (OR, 2.8; CI, 1.5-5.4; P < .05). Poor nutritional status before peripheral artery bypass surgery is an independent predictor of postoperative mortality and extended length of hospital stay.