Abstract
ObjectivesTo explore the risk factors of preoperative hypoalbuminemia and its’ effects on complications in the elderly with primary hip arthroplasty.MethodsA total of 211 elderly inpatients who underwent hip arthroplasty were collected. All patients were divided into the control group (preoperative serum albumin ≥35 g/L) and case group (preoperative serum albumin <35 g/L). The risk factors of preoperative hypoalbuminemia and the postoperative complications were analyzed.ResultsCompared to controls, hypoalbuminemia patients were older (P = 0.026), had lower BMI (P = 0.045), higher cardiac function score (P < 0.0001), higher ASA scores (P = 0.023), and longer hospital stay (P < 0.001). The intraoperative albumin loss in the case group was significantly higher than that of in control group (P < 0.001), but there was no significant difference in operation time and intraoperative blood loss between the two groups (P >0.05). Compared to controls, hypoalbuminemia patients had a higher risk for any complication (P = 0.014), such as delayed wound healing, pleural effusion, and pneumonia. The risk of postoperative complications increased by 6.9% with every 1 year old is increasing (age > 60). The risk of postoperative complications in the case group was 1.89 times higher than that in the control group.ConclusionPatients with older age, poor nutritional status, and more than 2 concomitant diseases are more likely to develop preoperative hypoalbuminemia. Preoperative hypoalbuminemia is related to the increased incidence of postoperative complications. Perioperative albumin loss is not only due to perioperative blood loss, but also related to vascular permeability and abnormal albumin metabolism.
Highlights
Serum albumin is the most abundant protein in human plasma, which plays an important role in maintaining normal physiological function [1]
The intraoperative albumin loss in the control group was significantly higher than that of in case group (P < 0.001), but there was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05) (Fig. 2)
The results showed that the amount of postoperative albumin loss in the case group was significantly lower than that in the control group, no matter in the patients who received total hip arthroplasty (THA) or hip arthroplasty (HHA) (P < 0.05), but there was no significant difference in operation time and intraoperative blood loss between the two groups (P > 0.05)
Summary
Serum albumin is the most abundant protein in human plasma, which plays an important role in maintaining normal physiological function [1]. Hypoalbuminemia was defined as a serum albumin
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