Role of Albumin as a Nutritional and Prognostic Marker in Elective Intestinal Surgery

被引:25
作者
Galata, Christian [1 ]
Busse, Linda [1 ]
Birgin, Emrullah [1 ]
Weiss, Christel [2 ]
Hardt, Julia [1 ]
Reissfelder, Christoph [1 ]
Otto, Mirko [1 ]
机构
[1] Heidelberg Univ, Med Fac Mannheim, Univ Med Mannheim, Dept Surg, Mannheim, Germany
[2] Heidelberg Univ, Med Fac Mannheim, Dept Med Stat & Biomath, Mannheim, Germany
关键词
SERUM-ALBUMIN; RISK; OUTCOMES; DISEASE; SCORE; COMPLICATIONS; MALNUTRITION; INFLAMMATION; ASSOCIATION; SITE;
D O I
10.1155/2020/7028216
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. The aim of this study was to investigate albumin, nutritional status, and inflammation in the perioperative course of patients undergoing elective intestinal surgery. Methods. A retrospective analysis of patients with preoperative measurements of nutritional parameters who underwent intestinal surgery between April 2017 and August 2018 at our institution was performed. Preoperatively, the correlation of albumin levels with markers for inflammation and nutritional status was investigated. Postoperatively, albumin levels were assessed with regard to high-grade morbidity and inflammation. Results. A total of 105 patients were included. Preoperatively, albumin levels were correlated with both markers for nutritional status and inflammation, with phase angle (PA) (p=0.004) and C-reactive protein (CRP) (p<0.001) as independent factors predicting the albumin levels in multivariable analysis. Postoperatively, the reduction in serum albumin ( increment -albumin) on postoperative day (POD) 1/2 (p=0.025) and POD 4/5 (p=0.003) was significantly associated with Clavien-Dindo complications >= grade III. A cut-off value of 27.3% for increment -albumin on POD 1/2 predicted postoperative high-grade morbidity (sensitivity 75% and specificity 69%). The product of increment -albumin and CRP on POD 4/5 identified patients with major complications more reliably than increment -albumin or CRP alone (sensitivity 91% and specificity 72%). Conclusion. Preoperatively, albumin was a marker for nutritional status even if an inflammatory component was present. Postoperatively, increment -albumin on POD 1/2 predicted high-grade morbidity. A new marker to identify patients with major complications on POD 4/5 is presented.
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页数:8
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共 30 条
[21]   Handgrip Strength Index Predicts Nutritional Status as a Complement to Body Mass Index in Crohn's Disease [J].
Lu, Ze Lan ;
Wang, Tian Rong ;
Qiao, Yu Qi ;
Zheng, Qing ;
Sun, Ying ;
Lu, Jun Tao ;
Han, Xiao Xiao ;
Fan, Zhu Ping ;
Ran, Zhi Hua .
JOURNAL OF CROHNS & COLITIS, 2016, 10 (12) :1395-1400
[22]   Even modest hypoalbuminemia affects outcomes of colorectal surgery patients [J].
Moghadamyeghaneh, Zhobin ;
Hwang, Grace ;
Hanna, Mark H. ;
Phelan, Michael J. ;
Carmichael, Joseph C. ;
Mills, Steven D. ;
Pigazzi, Alessio ;
Dolich, Matthew O. ;
Stamos, Michael J. .
AMERICAN JOURNAL OF SURGERY, 2015, 210 (02) :276-284
[23]   Nutritional parameters predicting pressure ulcers and short-term mortality in patients with minimal conscious state as a result of traumatic and non-traumatic acquired brain injury [J].
Montalcini, Tiziana ;
Moraca, Marta ;
Ferro, Yvelise ;
Romeo, Stefano ;
Serra, Sebastiano ;
Raso, Maria Girolama ;
Rossi, Francesco ;
Sannita, Walter G. ;
Dolce, Giuliano ;
Pujia, Arturo .
JOURNAL OF TRANSLATIONAL MEDICINE, 2015, 13
[24]   Impact of Early Enteral Nutrition on Nutritional and Immunological Outcomes of Gastric Cancer Patients Undergoing Gastrostomy: A Systematic Review and Meta-Analysis [J].
Nikniaz, Zeinab ;
Somi, Mohammad Hossein ;
Nagashi, Shahnaz ;
Nikniaz, Leila .
NUTRITION AND CANCER-AN INTERNATIONAL JOURNAL, 2017, 69 (05) :693-701
[25]   An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site: a Glasgow Inflammation Outcome Study [J].
Proctor, M. J. ;
Morrison, D. S. ;
Talwar, D. ;
Balmer, S. M. ;
O'Reilly, D. S. J. ;
Foulis, A. K. ;
Horgan, P. G. ;
McMillan, D. C. .
BRITISH JOURNAL OF CANCER, 2011, 104 (04) :726-734
[26]   The relationship between malnutrition risk and clinical outcomes in a cohort of frail older hospital patients [J].
Slee, Adrian ;
Birch, Deborah ;
Stokoe, David .
CLINICAL NUTRITION ESPEN, 2016, 15 :57-62
[27]   Preoperative Nutrition Status and Postoperative Outcome in Elderly General Surgery Patients: A Systematic Review [J].
van Stijn, Mireille F. M. ;
Korkic-Halilovic, Ines ;
Bakker, Marjan S. M. ;
van der Ploeg, Tjeerd ;
van Leeuwen, Paul A. M. ;
Houdijk, Alexander P. J. .
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, 2013, 37 (01) :37-43
[28]   Body Mass Index Is a Marker of Nutrition Preparation Sufficiency Before Surgery for Crohn's Disease From the Perspective of Intra-Abdominal Septic Complications A Retrospective Cohort Study [J].
Zhang, Min ;
Gao, Xiang ;
Chen, Yuanhan ;
Zhi, Min ;
Chen, Huangwei ;
Tang, Jian ;
Su, Minli ;
Yao, Jiayin ;
Yang, Qingfan ;
Chen, Junrong ;
Hu, Pinjin ;
Liu, Huanliang .
MEDICINE, 2015, 94 (35) :e1455
[29]   Preoperative skeletal muscle index vs the controlling nutritional status score: Which is a better objective predictor of long-term survival for gastric cancer patients after radical gastrectomy? [J].
Zheng, Zhi-Fang ;
Lu, Jun ;
Xie, Jian-Wei ;
Wang, Jia-Bin ;
Lin, Jian-Xian ;
Chen, Qi-Yue ;
Cao, Long-Long ;
Lin, Mi ;
Tu, Ru-Hong ;
Zheng, Chao-Hui ;
Huang, Chang-Ming ;
Li, Ping .
CANCER MEDICINE, 2018, 7 (08) :3537-3547
[30]   CONSORT: Different End-Points of Preoperative Nutrition and Outcome of Bowel Resection of Crohn Disease A Randomized Clinical Trial [J].
Zhu, Weiming ;
Guo, Zhen ;
Zuo, Lugen ;
Gong, Jianfeng ;
Gu, Lili ;
Cao, Lei ;
Li, Ning ;
Li, Jieshou .
MEDICINE, 2015, 94 (29)