Impact of albumin levels on clinical outcomes in children underwent abdominal surgery

Abstract

Background Patients underwent abdominal surgery and had hypoalbuminemia were at risk of post-operative complications. The prognostic role of albumin levels in children with abdominal surgery remains unclear.
 Objective To investigate the impact of albumin levels on clinical outcomes related to the complications in children with abdominal surgery.
 Methods This was a retrospective cohort study on children aged 29 days to 18 years, who underwent abdominal surgery, had serum albumin levels measured at pre-operative and within 48 hours post-operatively, and hospitalized in Paediatric Intensive Care Unit of Dr. Cipto Mangunkusumo Hospital, Indonesia. The primary outcomes were post-operative complications (sepsis, surgical site infection, shock), length of stay in PICU, dehiscence, relaparotomy, and postoperative mortality.
 Results This study recruited a total of 201 children. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were found in 15.4% and 51.2%, respectively. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were associated with higher risk of post-operative sepsis (RR 3.4; 95%CI 1.54 to 7.51) and relaparotomy (RR 3.84; 95%CI 1.28 to 1.49). The median of length of PICU stay was 4 days longer in children with pre-operative serum albumin levels ≤ 3.00 g/dL (P<0.001).
 Conclusions Hypoalbuminemia condition in children undergo abdominal surgery is associated with increased risk of post-operative sepsis, longer length of stay in PICU, and risk of relaparotomy.

The Pattern of Nutritional and Inflammatory Parameters in Children with Acute Appendicitis

“…This finding is close to a prior report which concluded that hypoalbuminemia in children undergoing abdominal surgery is linked to the increased risk of postoperative longer hospital LOS. 40 Additionally, preoperative serum albumin showed inverse significant correlations with both preoperative TLC and CRP, a relation which is close to a previous report which yielded that there was a persistent elevation of systemic inflammatory blood-borne markers (TLC and CRP) with a continued persistent reduction in albumin in patients who had undergone esophageal resections. 41 Additionally, the role of GPS was also investigated in infections.…”

Preoperative hypoalbuminemia and severe acute malnutrition as prognostic factors for postoperative complications in major abdominal surgery: A single-center retrospective study

“…Dewi et al reported that preoperative albumin levels of ≤3.0 g/dL were predictors of increased risk of postoperative complications, such as sepsis and the need for relaparotomy. 6 A study also reported that a preoperative albumin level of 2.5 -3.45 g/dL predicts an increased risk of postoperative abdominal surgical site infection complications. 10 Albumin serves a vital biological function in the body, specifically in maintaining plasma oncotic pressure and transporting bilirubin, fatty acids, and drugs.…”

“…This figure was lower compared to that of another study (36.3%). 6 We discovered that severe acute malnutrition was a significant prognostic factor for the occurrence of postoperative complications. Similarly, a study conducted at the same hospital on children who underwent laparotomy reported that 57.1% of pediatric patients with poor nutritional status experienced postoperative complications or death.…”