Role of serum albumin and body mass index as predictors of post-operative morbidity and mortality in elective major abdominal surgeries

Abstract

Background: The adverse effects of malnutrition on the morbidity and mortality of patients was first recognized by Hippocrates (460 BC- 370 BC) many centuries ago. It is common and occurs in about 30% of surgical patients with gastrointestinal diseases and in up to 60% of those in whom hospital stay has been prolonged because of postoperative complications. There is a substantial evidence to show that patients who have signs of malnutrition have a higher risk of complications and an increased risk of death in comparison with patients who have adequate nutritional reserves. Nutritional assessment is essential for identifying patients who are at risk of developing complications related to significant malnutrition. Methods: All the collected data was entered in Microsoft Excel sheet. It was then transferred to SPSS ver. 17 software for statistical analysis. Quantitative data was compared by using student’s t-test and qualitative data compared using frequency and usage. Efficacy of serum albumin and BMI as screening test to predict the occurance of complications in patients was compared using roc curve. P value of < 0.05 considered as significant. Results: Even though body mass index was associated with postoperative complications but serum albumin was better prognostic indicator than body mass index. Conclusions: Majority of patients had serum albumin < 2.5 gm/dl and more complications were seen with serum albumin < 3.5 gm/dl which was statistically significant (p value 0.01). Sr. albumin is a good prognostic indicator because of its ability to detect protein energy malnutrition.