Preoperative Low Albumin Levels Research Articles

Correlation Between Preoperative Serum Albumin Levels And Post-Operating Seroma Incidence Of Modified Radical Mastectomy In Breast Cancer Patients

Background: Surgical therapy is still the mainstay of therapy for breast cancer, and modified radical mastectomy (MRM) is the most frequently performed procedure. Seroma formation after breast surgery is a complication that is often found due to the formation of dead space anatomically. A low albumin level indicates an ongoing systemic response and is a one of marker for a seroma. Aim To determine the postoperative complications of modified radical mastectomy in breast cancer patients, namely the incidence of postoperative seroma with preoperative serum albumin levels. Methods: An analytic observational study using a cross sectional study design conducted at the medical record of Prof. Dr. IGNG Ngoerah Denpasar Hospital in January 2019-December 2021. The research subjects were all patients with breast cancer underwent MRM. This study’s data analysis consisted of univariate and bivariate analysis using IBM SPSS version 23. Results: 128 subjects divided into two groups, 30 subjects with seroma and 98 subjects without seroma. Low albumin levels <3.5 gr/dl in the seroma group were found in 18% case and in the group without seromas 39.1%, normal albumin levels > 3.5 gr/dl with seromas occurring in 5.5% respondents and normal albumin levels without seroma found 37.5% respondents. The RR value was 2.4 (CI 95% 1.14-5.34) with a p-value of 0.013. Conclusion: Pre-operative low albumin level < 3.5 gr/dl correlated to high seroma formation after modified radical mastectomy.

Perioperative factors associated with pressure ulcer development after major surgery.

BackgroundPostoperative pressure ulcers are important indicators of perioperative care quality, and are serious and expensive complications during critical care. This study aimed to identify perioperative risk factors for postoperative pressure ulcers.MethodsThis retrospective case-control study evaluated 2,498 patients who underwent major surgery. Forty-three patients developed postoperative pressure ulcers and were matched to 86 control patients based on age, sex, surgery, and comorbidities.ResultsThe pressure ulcer group had lower baseline hemoglobin and albumin levels, compared to the control group. The pressure ulcer group also had higher values for lactate levels, blood loss, and number of packed red blood cell (pRBC) units. Univariate analysis revealed that pressure ulcer development was associated with preoperative hemoglobin levels, albumin levels, lactate levels, intraoperative blood loss, number of pRBC units, Acute Physiologic and Chronic Health Evaluation II score, Braden scale score, postoperative ventilator care, and patient restraint. In the multiple logistic regression analysis, only preoperative low albumin levels (odds ratio [OR]: 0.21, 95% CI: 0.05–0.82; P < 0.05) and high lactate levels (OR: 1.70, 95% CI: 1.07–2.71; P < 0.05) were independently associated with pressure ulcer development. A receiver operating characteristic curve was used to assess the predictive power of the logistic regression model, and the area under the curve was 0.88 (95% CI: 0.79–0.97; P < 0.001).ConclusionsThe present study revealed that preoperative low albumin levels and high lactate levels were significantly associated with pressure ulcer development after surgery.

Risk factors for intra-abdominal sepsis after surgery in Crohn's disease.

This study examined risk factors for intra-abdominal sepsis after surgery in Crohn's disease. We reviewed 343 patients who underwent 1,008 intestinal anastomoses during 566 operations for primary or recurrent Crohn's disease between 1980 and 1997. Possible factors for intra-abdominal sepsis were analyzed by both univariate (chi-squared test) and multivariate (multiple regression) analyses. Intra-abdominal septic complications, defined as anastomotic leak, intra-abdominal abscess, or enterocutaneous fistula, developed after 76 operations (13 percent). Intra-abdominal septic complications were significantly associated with preoperative low albumin level (< 30 g/l; P = 0.04), preoperative steroids use (P = 0.03), abscess at the time of laparotomy (P = 0.03), and fistula at the time of laparotomy (P = 0.04). The intra-abdominal septic complication rate was 50 percent (8/16 operations) in patients with all of these four risk factors, 29 percent (10/35 operations) in patients with three risk factors, 14 percent (14/98 operations) in patients with two risk factors, 16 percent (33/209 operations) in patients with only one risk factor, and 5 percent (11/208 operations) in patients with none of these risk factors (P<0.0001). The following factors did not affect the incidence of septic complications; age, duration of symptoms, number of previous bowel resections, site of disease, type of operation (resection, strictureplasty, or bypass), covering stoma, and number, site, or method (sutured or stapled) of anastomoses. Preoperative low albumin level, steroid use, and the presence of abscess or fistula at the time of laparotomy significantly increased the risk of septic complications after surgery in Crohn's disease.