Prognostic significance of serum albumin urea ratio in suture line leakage of the alimentary tract.

Prognostic significance of postoperative changes in serum albumin and urea concentrations as well as their ratio was statistically evaluated in 73 patients with suture line leakage of the abdominal alimentary tract. Increase in serum urea was associated with poor prognosis regardless of the site of leakage. Although the serum albumin concentration was poorly correlated to prognosis, its ratio to serum urea was of more prognostic significance than the urea value alone. When the ratio of the serum albumin nitrogen to the urea nitrogen fell below 10, there was a sharp rise in mortality as well as in morbidity, associated with poor local defense reaction, high incidence of spreading peritonitis, severe systemic complications, and decreased tolerance to tube feeding as well as parenteral hyperalimentation. A special therapeutic policy was suggested for the management of leakage in patients with critically low albumin/urea ratios.