scholarly journals A Prospective Study to Correlate Preoperative Serum Albumin as a Predictor of Post-Operative Mortality and Morbidity

2021 ◽  
Vol 10 (18) ◽  
pp. 1291-1295
Author(s):  
Sagar Dilip Rathod ◽  
Dhirendra D. Wagh
Keyword(s):  
Clinical Outcome ◽  
Serum Albumin ◽  
Postoperative Mortality ◽  
Postoperative Outcome ◽  
Major Surgery ◽  
Albumin Concentration ◽  
Mortality And Morbidity ◽  
Male Predominance ◽  
Preoperative Serum ◽  
Number Of Patients

BACKGROUND In recent times serum albumin has been considered as a very important factor in determining the clinical outcome of a patient undergoing major surgery. Patients with low serum albumin pre-operatively have been encountered with poor outcome postoperatively. This study was conducted to assess the association between serum albumin concentration and postoperative outcome (morbidity / mortality). METHODS This prospective observational study was carried out in JNMC and AVBRH, Sawangi, Wardha, from September 2018 to September 2020. All patients undergoing emergency / elective major surgeries were included in the study. Detailed history of patients was recorded including chief complaints and any other previous medical history. RESULTS 104 patients were included in the study of which maximum number of patients were seen in the age range of 35 – 64 years. The mean age being 48.19 ± 15.60 years. The gender distribution with more male predominance with 59.62 % participants being males and 40.38 % participants being females. Total 68 patients had postoperative complications, 40 being males and 28 being females. Highest number of complications in this study were seen in age group 55 - 64 years. 50 out of 73 patients with benign diseases developed complications and 18 out of 31 patients with malignant diseases developed complications. CONCLUSIONS Serum albumin has become an important modality to define the clinical outcome of a patient. Surgeons have started using it as a marker to define the post-operative outcome of a patient undergoing surgery. Exogenous albumin administration has also showed promising results in improving the outcome of a patient in the post-operative period. KEY WORDS Hypoalbuminaemia, Serum Albumin, Postoperative Mortality, Postoperative Morbidity

EVALUATE PRELIMINARY RESULTS OF SURGERY FOR GASTRIC CANCER COMBINATED ADJUVANT CHEMOTHERAPY

2014 ◽  
pp. 111-119
Author(s):  
Quang Bo Nguyen ◽  
Manh Ha Le ◽  
Nhu Hiep Pham ◽  
Loc Le
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Postoperative Mortality ◽  
Stage Iv ◽  
Life Time ◽  
Disease Stage ◽  
Mortality And Morbidity ◽  
Preliminary Results ◽  
Number Of Patients ◽  
Results Of Surgery

Purpose: To review some characteristics of patients and evaluate preliminary results of adjuvant chemotherapy for patients with resected gastric cancer. Objectives and Methods:The study was conducted on 30 patients with gastric cancer (male/female = 20/10) treated by adjuvant chemotherapy after gastrectomy at the Digestive Surgical Depatment at Hue Central Hospital from January. 2011 to May. 2012. We noted their clinical and paraclinical signs and studied the preliminary results of adjuvant chemotherapy after gastrectomy for gastric cancer. Results: The male/female = 2/1, The common group of age is 41-60, accounting for 63,33%. The primary tumor were found mostly at antrum and pylorus (66,67%).The postoperative mortality and morbidity common rates were 0% and 3,33%. Almost patients treated by adjuvant chemotherapy from 4-8 weeks after gastrectomy (73,33%). Fatigue is the most common toxicity of chemotherapy with 33,33% and alopecia was 26,67%. The follow-up time is about 11 months (rank 6-15 months). The life time expectancy of all 30 patients by stages disease: Stage II: 100%, stage III: 94,17% and stage IV: 16,67%. Conclusion: We review general characteristics of patients, and evaluate the results of surgery, quality of life after surgery combine with supportive care. Number of patients with total points within the 8-10 points by Spitzer index from 70% to 80% after the second re-examination. Most of chemotherapy toxicity is tolerable. However, this study needs to be carry out in the longer time, with larger number of patients. Key words: gastric cancer, chemotherapy

scholarly journals Preoperative hypoalbuminemia was associated with acute kidney injury in high-risk patients following non-cardiac surgery: a retrospective cohort study

2019 ◽  
Author(s):  
Nan Li ◽  
Hong Qiao ◽  
Jing-Fei Guo ◽  
Hong-Yun Yang ◽  
Xue-Ying Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Serum Albumin ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Albumin Concentration ◽  
Multivariate Logistic Regression ◽  
Preoperative Serum ◽  
Postoperative Aki

Abstract Background: Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short- and long- term morbidity and mortality. Evidence shows that hypoalbuminemia is associated with increased AKI risk in patients with infectious diseases and cancer and following cardiac surgery and transplant surgery. However, little evidence is available on non-cardiac surgery population. Thus, we investigated the association between preoperative hypoalbuminemia and AKI following non-cardiac surgery. Methods: We retrospectively assessed perioperative risk factors and preoperative serum albumin concentration in 729 consecutive adult patients who underwent non-cardiac surgery from July 1, 2017, to June 30, 2018. Each patient was categorized according to maximal Kidney Disease Improving Global Outcomes criteria based on creatinine changes and urine output within the first week after surgery. Multivariate Logistic regression models were used to analyze the association between preoperative hypoalbuminemia and postoperative AKI. Results: Of 729 patients, 188 (25.8%) developed AKI. AKI incidence was higher in patients with preoperative serum albumin <37.5 g/L than in those with preoperative serum albumin ≥37.5 g/L [35.9% (98/273) vs. 19.7% (90/456), P<0.001]. Multivariate logistic regression analysis showed that preoperative serum albumin <37.5 g/L (odds ratio 1.892; 95% confidence interval 1.238-2.891; P=0.003) was independently associated with postoperative AKI. Patients with preoperative serum albumin <37.5 g/L tended to have a higher but not significant ratio in AKI stage 2 (2.6% vs 1.1%, P=0.144) and much higher ratio in AKI stage 3 (4.8% vs 0.7%, P<0.001) than those with preoperative serum albumin ≥37.5 g/L. AKI patients had a higher in-hospital mortality rate [6.9% (13/188) vs. 0.2% (1/541), P<0.001]. Kaplan-Meier analysis revealed that the cumulative survival rate decreased with increasing AKI severity (P<0.001). Postoperative AKI was also associated with other worse outcomes, such as prolonged mechanical ventilation [53.4 (33.0, 73.8) vs 14.7 (11.1, 18.3) hours, P<0.001], intensive care unit stay [4.0 (3.1, 4.9) vs 2.0 (1.8, 2.3) days, P<0.001], postoperative hospital stay [17.8 (14.8, 20.9) vs 12.3 (11.3, 13.3) days, P<0.001], and higher total cost [13,453 (8,538, 20,228) vs 11,306 (6,277, 16,400) dollars, P<0.001]. Conclusions: Preoperative hypoalbuminemia was independently associated with AKI after non-cardiac surgery, and postoperative AKI was associated with poor outcomes.

High Neutrophil to Lymphocyte Ratio Is Associated With Symptomatic and Ruptured Thoracic Aortic Aneurysm

Angiology ◽  
2018 ◽  
Vol 69 (8) ◽  
pp. 686-691 ◽  
Author(s):  
Fabien Lareyre ◽  
Juliette Raffort ◽  
Duy Le ◽  
Hon Lai Chan ◽  
Thomas Le Houerou ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Postoperative Morbidity ◽  
Surgical Repair ◽  
Postoperative Mortality ◽  
Postoperative Outcome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Mortality And Morbidity ◽  
Lymphocyte Ratio ◽  
Significant Difference

The predictive value of the neutrophil to lymphocyte ratio (NLR) has been demonstrated in several cardiovascular diseases. The aim of our study was to investigate the association between the preoperative NLR and aneurysm characteristics as well as 30-day postoperative morbidity and mortality in patients with thoracic aortic aneurysm (TAA) undergoing aortic surgical repair. Consecutive patients (n = 75) with TAA were retrospectively included over a 10-year period. Clinical characteristics, aneurysm characteristics, and 30-day postoperative outcome were recorded. The median age of patients was 71 (67-80) years. The median preoperative NLR was 3.5 (2.3-5.8). The proportion of asymptomatic TAA was significantly lower in patients with an NLR > 3.5 compared with those with an NLR < 3.5 (52.6% vs 75.7%; P = .054). The proportion of patients with pain or with ruptured TAA was significantly higher in patients with an NLR > 3.5 compared with those with NLR < 3.5 (42.1% vs 16.2%; P = .022 and 26.3% vs 2.7%; P = .007, respectively). No significant difference was observed regarding the 30-day overall postoperative mortality and morbidity. The preoperative NLR did not correlate with TAA diameter. A high preoperative NLR is significantly associated with symptomatic and ruptured TAA, suggesting a potential interest as a marker and/or player in the disease.

Abstract 18: Seasonal Characteristic Of Kawasaki Disease With The Onset At The Different Seasons

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Yukie Ozeki ◽  
Fumiya Yamada ◽  
Tsuyoshi Kishimoto ◽  
Yosikazu Nakamura
Keyword(s):  
Kawasaki Disease ◽  
Serum Albumin ◽  
Epidemiologic Study ◽  
Seasonal Trend ◽  
Albumin Concentration ◽  
Female Ratio ◽  
Number Of Patients ◽  
Different Seasons ◽  
Patient Groups ◽  
The Difference

Background: Kawasaki disease (KD) has been diagnosed in more than 60 countries. Seasonal trend of the patients with KD is observed in many countries. Little is known about the difference between the patient groups in the term of high incidence. Objective: The aim of this study was to characterize the two patient groups during the winter and summer seasons in Japan. Methods: Epidemiologic characteristics were compared between January and July, through the 22th nationwide survey included patients who visited hospitals during 2011-2012. The proportions of survey items were observed by age-adjustment. Results: The total number of patients during 2011-12 was 26,691, the number of patients was 2812 in January and 2302 in July, and the male/female ratio was 1.4, respectively. The patients <3 years account for 66% of each group (1854/2812, 1530/2302). The proportion of <8 months of age was 13.0% (365/2812) in January, 17.8% (409/2302) in July, that of 15 months to 3 years was 38.8% (1092/2812), and 33.5% (771/2302). Concurrence with the diagnostic guidelines was examined, the typical cases in July were 1.6% lower than in January, and the suspected cases were 1.3% higher than in January. The suspected cases of less than 4 principle symptoms had 5.3% higher than in January. The treatment cases with γ-globulin started within 5 days of illness were 2.2% less than in July. The cases of cardiac sequelae (giant aneurysm, aneurysm, dilatation, and stenosis) were 0.3% higher than in July. The cases of serum albumin concentration less than 3.2g/dL were 3.6% higher than in July. The percentage of occurrence cardiac sequelae in this class was 9.5% higher than in July. Discussion: The difference in age distribution in the two patient groups diagnosed in January and July was observed. The symptom had a slight difference, too. These result do not contradict a hypothesis that onset of KD is concerned with plural infections with different seasonal trend and targeting for the specific age. The association between low levels of serum albumin and cardiac sequelae has been known. The association between this class and the patients in the specific season will be clear in future epidemiologic study. Conclusion: This study clarified part of the characteristic of the patient diagnosed in the different seasons.

Hypoalbuminemia Predicts Adverse Events following Unicompartmental Knee Arthroplasty

2021 ◽  
Author(s):  
Edward S. Hur ◽  
Daniel D. Bohl ◽  
Craig J. Della Valle ◽  
Felipe Villalobos ◽  
Tad L. Gerlinger
Keyword(s):  
Adverse Events ◽  
Serum Albumin ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Nutritional Deficiencies ◽  
Albumin Concentration ◽  
Serum Albumin Concentration ◽  
Improvement Program ◽  
Unicompartmental Knee ◽  
Preoperative Serum

AbstractHypoalbuminemia is a potentially modifiable risk factor associated with adverse events following total knee arthroplasty. The present study aimed to evaluate whether hypoalbuminemia similarly predisposes to adverse events following unicompartmental knee arthroplasty (UKA). Patients who underwent UKA during 2006–2018 were identified through the American College of Surgeons National Surgical Quality Improvement Program. Only patients with preoperative serum albumin concentration were included. Outcomes were compared between patients with and without hypoalbuminemia (serum albumin concentration < 3.5 g/dL). All associations were adjusted for demographic, comorbidity, and laboratory differences between populations. A total of 11,342 patients were identified, of whom 6,049 (53.3%) had preoperative serum albumin laboratory values available for analysis. After adjustment for potential confounders, patients with hypoalbuminemia had a greater than 2-fold increased probability for occurrence of any complication (7.02% vs. 2.23%, p = 0.009) and a 4-fold increased probability of receiving a blood transfusion (1.81% vs. 0.25%, p = 0.045). Among procedures performed as inpatients, mean postoperative length of stay (LOS) was longer in patients with hypoalbuminemia (2.2 vs. 1.8 days; p = 0.031). Hypoalbuminemia is independently associated with complications and increased LOS following UKA and a marker for patients at higher risk of postoperative complications. Patients should be screened for hypoalbuminemia and nutritional deficiencies addressed prior to UKA.

scholarly journals Identification of Predictors of Surgical Site Infection in Patients With Gastric Cancer Undergoing Surgery With Curative Intent

2017 ◽  
Vol 102 (3-4) ◽  
pp. 157-164 ◽  
Author(s):  
Yuji Toiyama ◽  
Tadanobu Shimura ◽  
Hiromi Yasuda ◽  
Shigeyuki Yoshiyama ◽  
Susumu Saigusa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Serum Albumin ◽  
Surgical Site Infection ◽  
Operation Time ◽  
Albumin Concentration ◽  
Site Infection ◽  
Curative Surgery ◽  
Neutrophil Lymphocyte Ratio ◽  
Preoperative Serum ◽  
Duration Of Surgery

Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. The purpose of this study was to determine preoperative and operative predictors of SSIs after gastric resection with lymphadenectomy in patients with gastric cancer (GC). Data on clinicopathologic factors, including operative and preoperative laboratory factors, for 384 patients with GC who had undergone curative surgery were analyzed in this retrospective study to assess their associations with SSIs. Superficial/deep incisional SSIs (iSSIs) and organ/space SSIs (o/sSSIs) occurred in 18 (4.6%), and 27 (7.0%), respectively. The o/sSSIs were significantly associated with surgery-related factors such as duration of operation, blood loss, and extent of tumor. Additionally, high levels of preoperative indicators of systemic inflammation, including neutrophil counts, neutrophil/lymphocyte ratio, and C-reactive protein concentrations, were significantly associated with o/sSSIs. Multivariate analyses demonstrated that preoperative neutrophil counts and duration of surgery were independent predictors for o/sSSIs, whereas only preoperative serum albumin concentration was predicted for iSSIs. In patients with GC undergoing curative surgery, preoperative neutrophil count and operation time are potentially valuable predictors of o/sSSIs, whereas only preoperative serum albumin predicts iSSIs.

scholarly journals Thirty-Day Perioperative Complications, Prolonged Length of Stay, and Readmission Following Elective Posterior Lumbar Fusion Associated With Poor Nutritional Status

2018 ◽  
Vol 9 (4) ◽  
pp. 417-423 ◽  
Author(s):  
Kevin Phan ◽  
William Ranson ◽  
Samuel J. W. White ◽  
Zoe B. Cheung ◽  
Jun Kim ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Lumbar Fusion ◽  
Postoperative Mortality ◽  
Unplanned Readmission ◽  
Albumin Concentration ◽  
Improvement Program ◽  
Posterior Lumbar Fusion ◽  
Prolonged Length ◽  
Preoperative Serum ◽  
Perioperative Complication

Study Design: Retrospective study. Objective: To determine the rates of early postoperative mortality and morbidity in adults with hypoalbuminemia undergoing elective posterior lumbar fusion (PLF). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) was examined from 2005 to 2012. Current Procedural Terminology (CPT) codes were used to query the database for adults (≥18 years) who underwent PLF and/or posterior/transforaminal lumbar interbody fusion (PLIF/TLIF). Patients were divided into those with normal albumin concentration (≥3.5g/dL) and those with hypoalbuminemia (<3.5 g/dL). Both univariate and multivariate analyses were performed. Results: A total of 2410 patients were included, of whom 2251 (93.4%) were normoalbuminemic and 159 (6.6%) were hypoalbuminemic. Patients with preoperative serum albumin levels <3.5 g/dL were older with a higher American Society of Anesthesiologists (ASA) score, and more comorbidities, including anemia, diabetes, dependent functional status, and preoperative history of chronic steroid therapy. Hypoalbuminemic patients had higher rates of any 30-day perioperative complication ( P < .001), unplanned readmission ( P = .019), and prolonged length of stay (LOS) >5 days ( P < .001). However, hypoalbuminemia was not significantly associated with any specific perioperative complication. On multivariate analysis, preoperative hypoalbuminemia was found to be an independent predictor of prolonged LOS (OR 2.4, 95% CI 1.7-3.5; P < .001) and unplanned readmission (OR 2.7, 95% CI 1.1-6.3; P = .023). Conclusion: Hypoalbuminemia was found to be an important predictor of patient outcomes in this population. This study suggests that clinicians should consider nutritional screening and optimization as part of the preoperative risk assessment algorithm. Level of Evidence: III

scholarly journals Comparison of Hemodialysis and Peritoneal Dialysis Patients’ Dietary Behaviors

2019 ◽  
Author(s):  
Seonmi Kim ◽  
Byung Chin Kang ◽  
Hyun-Jung Kim ◽  
Min-Sook Kyung ◽  
Hyung Jung Oh ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Nutrient Intake ◽  
Dietary Behavior ◽  
Albumin Concentration ◽  
Dialysis Patients ◽  
Protein Energy Wasting ◽  
Mortality And Morbidity ◽  
Protein Energy ◽  
Major Nutrients

Abstract Background: Nutritional factors are associated with high mortality and morbidity in dialysis patients, and protein-energy wasting is regarded as an important one. The modality of dialysis may affect patients’ dietary behavior and nutritional status, but no study has compared the dietary behavior, nutrient intake, and nutritional adequacy of hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: From December 2016 to May 2017, a dietary behavior survey and Semi-quantitative Food Frequency Questionnaire (Semi-FFQ) were conducted, and laboratory parameters were obtained. The results of prevalent HD and PD patients were then compared. Results: In the dietary behavior survey, HD patients showed more appropriate dietary behavior patterns overall than PD patients. In the dietary intake analysis with the Semi-FFQ, energy intake was significantly lower in the PD group than in the HD group due to the lower intake of carbohydrates, fat, and protein. In the nutrient intake-to-recommended allowance ratio analysis, both HD and PD patients revealed inadequate intake amounts for most major nutrients. Serum albumin and potassium levels were significantly higher in HD than in PD patients. Serum albumin concentration showed a positive correlation with dietary protein and calcium intake in the PD group. Conclusion: According to this study, the dietary behavior and nutritional intake of prevalent PD patients were worse than those of HD patients.

scholarly journals Management Strategy and Outcome of Epidural Haematoma in Relation to Volume

1970 ◽  
Vol 6 (2) ◽  
pp. 89-91
Author(s):  
MM Islam ◽  
TH Bhuiyan ◽  
MK Hassan ◽  
MATM Asadullah ◽  
Z Raihan ◽  
...  
Keyword(s):  
Management Strategy ◽  
Head Injuries ◽  
Epidural Haematoma ◽  
College Hospital ◽  
Early Management ◽  
Mortality And Morbidity ◽  
Male Predominance ◽  
Medical College ◽  
Number Of Patients ◽  
Fall From Height

Epidural Haematoma (EDH) develops in 1-3% of all major head injuries and most common in the young. This crosssectional descriptive study was done to find out the management strategy and outcome of EDH in relation to clot volume. This study was performed from December'2006 to November'2007, by purposively selecting 77 cases of EDH from the Department of Neurosurgery, Dhaka Medical College Hospital (DMCH), Dhaka. The study showed that highest number of patients was in most active period of life, with male predominance (Male: Female =7.5:1). Causes of EDH were mostly due to assault (37.7%), followed by RTA (32.5%) and fall from height (29.8%). The study showed Patient having EDH Volume (EDHV) > 30ml will have 8.55 times more chance of having unfavorable outcome than patient having EDHV < 30 ml. Patient having EDHV > 30 ml will have 187.83 times more chance of requiring surgical intervention than those having EDHV <30 ml, which is statistically highly significant (p<0.001). Mortality rate of EDH can be reduced by giving early management either conservative or surgery. Delay in the management of EDH patients with poor level of consciousness and EDHV >30 ml has adverse effect on mortality and morbidity. Key words: EDH; EDHV; Burr hole; GOS; GCS. DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9208 FMCJ 2011; 6(2): 89-91

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