Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
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Objective To determine the relationship between preoperative hypoalbuminemia and the development of complications aftergynecological cancer surgery, as well as postoperative bowel function and hospital stay. Methods The medical records of 533 patients with gynecological cancer surgery at Konkuk University Hospital between 2005 and 2013were reviewed. Serum albumin level <3.5 g/dL was defined as hypoalbuminemia. All perioperative complications within 30-days after surgery, time to resumption of normal diet and length of postoperative hospital stay, were analyzed. Regressionmodels were used to assess predictors of postoperative morbidity. Results The median age was 49 years (range, 13 to 85 years). Eighty patients (15%) had hypoalbuminemia. Hypoalbuminemic patientshad significantly higher consumption of alcohol >2 standard drinks per day, lower American Society of Anesthesiologist score,higher frequency of ascites, and more advanced stage compared with non-hypoalbuminemic patients. Overall complicationrate within 30-days after surgery was 20.3% (108 out of 533). Hypoalbuminemic patients were more likely to developpostoperative complications compared to non-hypoalbuminemic patients (34.3% vs. 17.8%, P=0.022), and had significantlylonger median time to resumption of normal diet (3.3 [1–6] vs. 2.8 [0–15] days, P=0.005) and length of postoperative hospitalstay (0 [7–50] vs. 9 [1–97] days, P=0.014). In multivariate analysis, age >50 (odds ratio [OR], 2.478; 95% confidence interval [CI],1.310 to 4.686; P=0.005), operation time (OR, 1.006; 95% CI, 1.002 to 1.009; P=0.006), and hypoalbuminemia (OR, 2.367; 95% CI,1.021 to 5.487; P=0.044) were the significant risk factor for postoperative complications. Conclusion Preoperative hypoalbuminemia in patients with elective surgery for gynecologic malignancy is an independent predictor of30-days postoperative complications. Identification of this subset and preoperative optimization of nutritional status mayimprove surgical outcomes.
Abstract
Objective To determine the relationship between preoperative hypoalbuminemia and the development of complications aftergynecological cancer surgery, as well as postoperative bowel function and hospital stay. Methods The medical records of 533 patients with gynecological cancer surgery at Konkuk University Hospital between 2005 and 2013were reviewed. Serum albumin level <3.5 g/dL was defined as hypoalbuminemia. All perioperative complications within 30-days after surgery, time to resumption of normal diet and length of postoperative hospital stay, were analyzed. Regressionmodels were used to assess predictors of postoperative morbidity. Results The median age was 49 years (range, 13 to 85 years). Eighty patients (15%) had hypoalbuminemia. Hypoalbuminemic patientshad significantly higher consumption of alcohol >2 standard drinks per day, lower American Society of Anesthesiologist score,higher frequency of ascites, and more advanced stage compared with non-hypoalbuminemic patients. Overall complicationrate within 30-days after surgery was 20.3% (108 out of 533). Hypoalbuminemic patients were more likely to developpostoperative complications compared to non-hypoalbuminemic patients (34.3% vs. 17.8%, P=0.022), and had significantlylonger median time to resumption of normal diet (3.3 [1–6] vs. 2.8 [0–15] days, P=0.005) and length of postoperative hospitalstay (0 [7–50] vs. 9 [1–97] days, P=0.014). In multivariate analysis, age >50 (odds ratio [OR], 2.478; 95% confidence interval [CI],1.310 to 4.686; P=0.005), operation time (OR, 1.006; 95% CI, 1.002 to 1.009; P=0.006), and hypoalbuminemia (OR, 2.367; 95% CI,1.021 to 5.487; P=0.044) were the significant risk factor for postoperative complications. Conclusion Preoperative hypoalbuminemia in patients with elective surgery for gynecologic malignancy is an independent predictor of30-days postoperative complications. Identification of this subset and preoperative optimization of nutritional status mayimprove surgical outcomes.
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