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

Background The purpose of this study was to evaluate the correlation between serum albumin level change (Delta ALB) and post-operative complications in patients with normal preoperative serum albumin after gastrectomy of gastric cancer. Methods A total of 193 patients undergoing curative (R0) gastrectomy from September 2015 to May 2017 were enrolled in this study. The risk factors for predicting post-operative complications were identified by univariate and multivariate analysis. The cut-off value and diagnostic accuracy of Delta ALB were measured by receiver operating characteristic curves. Delta ALB was defined as: (albumin level before surgery - albumin on post-operative day (POD) 1)/albumin level before surgery x 100%. Results A total of 60 patients (31.0%) had post-operative complications. Our results showed that the cut-off value of Delta ALB was 19.0%. Using a cut-off value of 19.0%, multivariate analysis identified that Delta ALB was able to predict post-operative complications as an independent factor (odds ratio 13.98, 95% confidence interval 6.048-32.32, P < 0.001). In addition, the area under the curve of Delta ALB is higher than C-reactive protein on POD 3 (0.773 versus 0633). Compared with patients with Delta ALB <19.0%, patients with Delta ALB >= 19.0% have higher risk of post-operative complications suffered (62.3 versus 13.7%, P < 0.001) and longer post-operative stay (22.1 +/- 13.5 versus 17.5 +/- 4.2, P < 0.001). Conclusion Delta ALB acted as an independent predictor in short-term complications for patients with normal preoperative serum albumin and its diagnostic accuracy was higher than C-reactive protein on POD 3. It is promising to be a precise and straight predictor for incidence of post-operative complications to patients with normal preoperative serum albumin.