Change in serum albumin level predicts short‐term complications in patients with normal preoperative serum albumin after gastrectomy of gastric cancer

Ai, Shichao; Sun, Feng; Liu, Zhijian; Yang, Zhengyang; Wang, Jiafeng; Zhu, Zhouting; Du, Shangce; Guan, Wei

doi:10.1111/ans.15363

Cited by 11 publications

(8 citation statements)

References 21 publications

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“…Ai et al found that in patients with normal preoperative albumin level and gastric cancer, ΔAlb was associated with postoperative complications (OR 14, 95% CI 6–32) (Ai et al, 2019 ). The authors found a discriminative threshold of relative ΔAlb on POD 1 at 19%.…”

Section: Resultsmentioning

confidence: 99%

Postoperative decrease of albumin (ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review

et al. 2022

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Background Postoperative complications are frequent after gastrointestinal surgery and early prediction remains an unmet need. Serum albumin shows a rapid decrease after surgery, and this decline (ΔAlb) may reflect the intensity of the surgical stress response and thereby be a predictor of postoperative complications. This study aimed to comprehensively review the available data on ΔAlb in gastrointestinal surgery. Methods PRISMA guidelines were followed to conduct a systematic review of the literature in MEDLINE and Embase. Studies assessing the role of ΔAlb to predict complications after gastrointestinal surgery were included. Results A total of 1256 articles were screened, and 16 studies were included in the final analysis: 7 prospective and 9 retrospective trials. Sensitivity of ΔAlb to predict postoperative complications ranged from 63 to 84%, whereas specificity ranged from 61 to 86%. Nine out of the 16 included studies established a threshold of ΔAlb to predict morbidity (range: 5–11 g/l or 14–27%). Conclusion ΔAlb appeared as a valuable and promising biomarker to anticipate complications after gastrointestinal surgery. Future efforts are needed to determine whether and how ΔAlb may be integrated in clinical practice to guide clinicians in the perioperative management of patients.

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Section: Resultsmentioning

confidence: 99%

Postoperative decrease of albumin (ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review

et al. 2022

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“…Studies of albumin and AGR in GC patients are mostly related to survival, and there are few studies which have examined the relationships of albumin and AGR with the risk of postoperative complications. Ai et al (10) stated that the rate of decrease in albumin values on the first day after surgery in GC patients may be a predictive factor for the risk of postoperative complications. In the current study, a statistically significant relationship was found between low AGR and length of stay in ICU, serious postoperative complications, anastomotic leakage, and in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Globulin, which constitutes two main components of serum proteins and contains albumin and inflammatory cytokines, which are generally indicators of nutritional status, plays an important role in cancer immunity and prognosis (7). Studies have been conducted on the albumin to globulin ratio (AGR), some of which have included only albumin to predict survival in various types of cancer and others which more recently have evaluated albumin and globulin together (8)(9)(10). There are only a few studies in the literature that have examined the relationship between AGR rate and GAC, in terms of severe postoperative complications, early mortality and TNM staging.…”

Section: Albümin-globulin Oranı Mide Kanseri Hastalarında Kısa Dönem Komplikasyonları öNgörür Mü?mentioning

confidence: 99%

Does the Albumin to Globulin Ratio Predict Short-term Complications in Gastric Cancer Patients?

Durhan¹,

Süleyman²,

Koşmaz³

et al. 2021

Konuralp Tıp Dergisi

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Objective: Gastric cancer (GC) is a cancer with poor prognosis despite advances in diagnosis and treatment methods, and postoperative morbidity and mortality rates are high. The aim of this study was to evaluate the predictive and early prognostic effect of the pre-treatment albumin to globulin ratio (AGR) in patients with gastric adenocarcinoma (GAC). Methods: The study included male and female patients who were operated on with the diagnosis of GAC in our general surgery clinic between January 2016 and November 2020. The demographic and postoperative histopathological findings, postoperative complications and in-hospital mortality findings of the patients were evaluated retrospectively from the hospital data. Results: Evaluation was made of a total of 70 patients operated on with the diagnosis of GAC. In the ROC curve analysis applied to the AGR ratio, the optimum cut-off value was 1.54. A statistically significant difference was found between the high (≥1.54) and low (<1.54) AGR groups in terms of intensive care unit (ICU) length of stay, serious postoperative complications, anastomotic leakage, and in-hospital mortality (p = 0.050, p = 0.016, p = 0.011; p = 0.005). In univariate analysis with postoperative serious complications, statistically significant results were found with age> 65 years, high American Society of Anesthesiologist (ASA) score and low AGR (p = 0.035, p <0.001, p = 0.016), whereas in multivariate analysis, only high ASA score was found to be an independent risk factor (p = 0.031). Conclusions:The results of this study demonstrated the relationship between low AGR and serious postoperative complications, anastomotic leakage and early mortality risk in GAC. The AGR ratio, which can be calculated from the albumin and globulin values used in routine clinical practice, can be used as a suitable prognostic factor in this patient group to enable the clinician to take the necessary preoperative precautions.

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“…Decreases of 14 and 19% in cut-off values for ALB have been suggested for recognizing patients at a high risk for complications after gastric cancer resection [ 9 , 10 ]. The role of albumin as an independent prognostic marker in ovarian tumors is debated [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Serum Albumin Kinetics in Major Ovarian, Gastrointestinal, and Cervico Facial Cancer Surgery

Motamed

Mariani

Suria

et al. 2022

IJERPH

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Hypoalbuminemia in major cancer surgery can lead to postoperative short and long-term complications. Our study was designed to detect albumin variations in three major cancer surgeries: ovarian debulking (DBK), major abdominal gastrointestinal surgery (ABD), and major cervico-facial, or ear, nose and throat cancer surgery (ENT). Single-center prospective study inclusion criteria were non-emergency procedures scheduled to last at least five hours. We performed hourly perioperative monitoring of the patients’ albuminemia and hemoglobinemia. Electronic charts were followed for at least five years for survival analysis. Sixty-three patients were analyzed: 30 in the DBK group, 13 in the ABD group, and 20 in the ENT group. There was a significant difference in albumin decrease between the ENT group and the two others (−19% at six hours in the ENT group versus -49% in the debulking group and −31% in the ABD group (p < 0.05). There was no significant difference between the DBK and ABD groups. The decrease in hemoglobin was not significantly different between the groups, and no significant difference was observed in long-term survival. DBK and ABD surgery yielded significant hypoalbuminemia. Therefore, the extent of decrease in serum albumin is probably not the only etiology of the specific postoperative complications of these major surgeries. No significant difference was noticed in five-year mortality, and no correlation was found in relation to the degree of intraoperative albumin kinetics.

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Change in serum albumin level predicts short‐term complications in patients with normal preoperative serum albumin after gastrectomy of gastric cancer

Cited by 11 publications

References 21 publications

Postoperative decrease of albumin (ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review

Postoperative decrease of albumin (ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review

Does the Albumin to Globulin Ratio Predict Short-term Complications in Gastric Cancer Patients?

Serum Albumin Kinetics in Major Ovarian, Gastrointestinal, and Cervico Facial Cancer Surgery

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