The association of hypoalbuminemia with early perioperative outcomes - A comprehensive assessment across 16 major procedures
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The association of hypoalbuminemia with early perioperative outcomes - A comprehensive assessment across 16 major procedures. / Meyer, Christian P; Rios-Diaz, Arturo J; Dalela, Deepansh; Ravi, Praful; Sood, Akshay; Hanske, Julian; Chun, Felix K H; Kibel, Adam S; Lipsitz, Stuart R; Sun, Maxine; Trinh, Quoc-Dien.
in: AM J SURG, Jahrgang 214, Nr. 5, 11.2017, S. 871-883.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The association of hypoalbuminemia with early perioperative outcomes - A comprehensive assessment across 16 major procedures
AU - Meyer, Christian P
AU - Rios-Diaz, Arturo J
AU - Dalela, Deepansh
AU - Ravi, Praful
AU - Sood, Akshay
AU - Hanske, Julian
AU - Chun, Felix K H
AU - Kibel, Adam S
AU - Lipsitz, Stuart R
AU - Sun, Maxine
AU - Trinh, Quoc-Dien
N1 - Copyright © 2016 Elsevier Inc. All rights reserved.
PY - 2017/11
Y1 - 2017/11
N2 - 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.
AB - 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.
KW - Aged
KW - Female
KW - Humans
KW - Hypoalbuminemia
KW - Male
KW - Middle Aged
KW - Postoperative Complications
KW - Prospective Studies
KW - Surgical Procedures, Operative
KW - Treatment Outcome
KW - Journal Article
U2 - 10.1016/j.amjsurg.2016.11.023
DO - 10.1016/j.amjsurg.2016.11.023
M3 - SCORING: Journal article
C2 - 29106849
VL - 214
SP - 871
EP - 883
JO - AM J SURG
JF - AM J SURG
SN - 0002-9610
IS - 5
ER -