Tan Sophia Bee Ting, Lin Xiaohui, Rosley Muhammad Farqhan, Lamparelli Michael
General Surgery, Rockhampton Hospital, Rockhampton, AUS.
Cureus. 2025 Feb 26;17(2):e79681. doi: 10.7759/cureus.79681. eCollection 2025 Feb.
Purpose Hypoalbuminemia, which is indicative of protein-energy malnutrition, is linked to increased morbidity and mortality in acute surgical patients due to increased catabolism. This study evaluates the relationship between preoperative serum albumin levels and postoperative morbidity and mortality in patients who underwent open abdominal surgery. Methodology We used the Operating Room Management Information System (ORMIS) and coding to retrospectively find a complete list of surgeries from January 2021 to June 2023 using the term "laparotomy" and "open surgery". Patient demographics, comorbidities, pre-operative serum albumin, laboratory parameters, surgical category, postoperative complications, length of hospital stay, and death up to postoperative day 30 were collected. Serum albumin less than 35g/L is considered as hypoalbuminemia in this study. Results A total of 182 patients were analyzed, with 101 having hypoalbuminemia (serum albumin<35 g/L) and 81 having normal albumin levels (serum albumin≥35 g/L). Patients with hypoalbuminemia had significantly lower haemoglobin levels (126 g/L vs. 142 g/L, p<0.001) and higher American Society of Anaesthesiologists (ASA) scores, with more patients classified as ASA 4 and 5 (33.7% and 12.9% vs. 14.8% and 9.9%, p=0.024). The median hospital stay was longer in the hypoalbuminemia group (10 vs. 7 days, p=0.006). Wound dehiscence was more frequent (11.9% vs. 2.5%, p=0.018), and mortality was significantly higher (11.9% vs. 3.7%, p=0.046), highlighting the association between low preoperative albumin and worse surgical outcomes. Conclusions Preoperative serum albumin effectively predicts surgical outcomes after open abdominal surgery. It serves as a valuable, cost-effective risk predictor that should be further explored for integration into preoperative assessments.
目的 低蛋白血症提示蛋白质 - 能量营养不良，由于分解代谢增加，其与急性外科手术患者发病率和死亡率的增加相关。本研究评估接受开腹手术患者术前血清白蛋白水平与术后发病率和死亡率之间的关系。
方法 我们使用手术室管理信息系统（ORMIS）并通过编码，回顾性地查找2021年1月至2023年6月期间使用术语“剖腹术”和“开放手术”的完整手术列表。收集患者人口统计学资料、合并症、术前血清白蛋白、实验室参数、手术类别、术后并发症、住院时间以及术后30天内的死亡情况。本研究中血清白蛋白低于35g/L被视为低蛋白血症。
结果 共分析了182例患者，其中101例患有低蛋白血症（血清白蛋白<35g/L），81例白蛋白水平正常（血清白蛋白≥35g/L）。低蛋白血症患者的血红蛋白水平显著较低（126g/L对142g/L，p<0.001），美国麻醉医师协会（ASA）评分较高，更多患者被归类为ASA 4级和5级（33.7%和12.9%对14.8%和9.9%，p = 0.024）。低蛋白血症组的中位住院时间更长（10天对7天，p = 0.006）。伤口裂开更频繁（11.9%对2.5%，p = 0.018），死亡率显著更高（11.9%对3.7%，p = 0.046），突出了术前白蛋白水平低与更差手术结果之间的关联。
结论 术前血清白蛋白有效地预测开腹手术后的手术结果。它是一种有价值、具有成本效益的风险预测指标，应进一步探索将其纳入术前评估。
