Preoperative albumin as a predictor of outcome in gastrointestinal surgery

Abstract

Summary Background & aims The relationship between preoperative plasma albumin concentration and postoperative clinical course was determined in patients undergoing elective major gastrointestinal tract surgery, taking into account the type of surgery and values for the remaining preoperative analytical parameters. Methods Retrospective observational study in patients undergoing elective gastrointestinal surgery, for whom preoperative albumin values were available. Patients were classified according to the type of surgery. The independent variables studied were: age, sex, serum albumin, the parameters routinely included in the preoperative analytical work-up performed in our hospital, neoplastic disease and the type of surgery. The dependent variables included morbidity, mortality, parenteral nutrition requirements and days of hospitalization. Univariate and multivariate statistical methods were applied. Results 158 patients were studied. On multivariate analysis, preoperative hypoalbuminemia was significantly associated with higher morbidity and lengthier hospital stay regardless of the type of surgery. Among the different procedures analyzed, gastroesophageal surgery was associated with highest morbidity, mortality, parenteral nutrition needs and hospital stay. Conclusions Preoperative albumin determination as a predictor of morbidity in patients undergoing major gastrointestinal tract surgery is an inexpensive, simple and effective test to include in the routine preoperative analytical workup of these patients.