Journal article
The association of hypoalbuminemia with early perioperative outcomes - A comprehensive assessment across 16 major procedures
The American journal of surgery, Vol.214(5), pp.871-883
11/01/2017
DOI: 10.1016/j.amjsurg.2016.11.023
PMID: 29106849
Abstract
Background: Poor nutritional status is thought to influence peri- and postoperative outcomes. We assessed the association of hypoalbuminemia, a surrogate for poor nutritional status, with perioperative outcomes in patients undergoing one of 16 major surgical procedures.
Methods: Patients undergoing one of 16 major surgeries were identified using the ACS-NSQIP (2005-2011). Risk-adjusted logistic regression models examined the association of hypoalbuminemia on perioperative outcomes.
Results: Overall, 204,819 complete cases were identified, of whom 25.4% underwent major cardiovascular, 19.0% orthopedic and 55.6% oncologic surgery. Patients with hypoalbuminemia had significantly higher rates of complications, reoperations, readmissions, prolonged length-of-stay and mortality (all p < 0.001). After adjustment, hypoalbuminemia was an independent predictor of overall complications in 12 of the procedures examined and 30-day mortality in 11 of the procedures. Individual perioperative complication profile varied widely among procedures.
Conclusions: Hypoalbuminemia exerts significant impact on perioperative outcomes. Its effect is procedure-specific and thus warrants targeted management strategies to improve surgical outcomes. In the absence of clear recommendations, our findings invite surgeons to assess preoperative albumin levels and to manage nutritional status accordingly. (c) 2016 Elsevier Inc. All rights reserved.
Details
- Title: Subtitle
- The association of hypoalbuminemia with early perioperative outcomes - A comprehensive assessment across 16 major procedures
- Creators
- Christian P. Meyer - Brigham and Women's HospitalArturo J. Rios-Diaz - Brigham and Women's HospitalDeepansh Dalela - Henry Ford Health SystemPraful Ravi - Brigham and Women's HospitalAkshay Sood - Ford Motor CompanyJulian Hanske - Brigham and Women's HospitalFelix K. H. Chun - Univ Med Ctr Hamburg Eppendorf, Dept Urol, Martinistr 52, D-20246 Hamburg, GermanyAdam S. Kibel - Brigham and Women's HospitalStuart R. Lipsitz - Brigham and Women's HospitalMaxine Sun - Brigham and Women's HospitalQuoc-Dien Trinh - Brigham and Women's Hospital
- Resource Type
- Journal article
- Publication Details
- The American journal of surgery, Vol.214(5), pp.871-883
- DOI
- 10.1016/j.amjsurg.2016.11.023
- PMID
- 29106849
- NLM abbreviation
- Am J Surg
- ISSN
- 0002-9610
- eISSN
- 1879-1883
- Publisher
- Elsevier
- Number of pages
- 13
- Grant note
- Professor Walter Morris-Hale Distinguished Chair in Urologic Oncology at Brigham and Women's Hospital Vattikuti Urology Institute
- Language
- English
- Date published
- 11/01/2017
- Academic Unit
- Urology
- Record Identifier
- 9984949468902771
Metrics
1 Record Views