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Open Access Publications from the University of California

Even modest hypoalbuminemia affects outcomes of colorectal surgery patients.

  • Author(s): Moghadamyeghaneh, Zhobin
  • Hwang, Grace
  • Hanna, Mark H
  • Phelan, Michael J
  • Carmichael, Joseph C
  • Mills, Steven D
  • Pigazzi, Alessio
  • Dolich, Matthew O
  • Stamos, Michael J
  • et al.

BACKGROUND: A small decrease in the serum albumin from the normal level is a common condition in preoperative laboratory tests of colorectal surgery patients; however, there is limited data examining these patients. We sought to identify outcomes of such patients. METHODS: The National Surgical Quality Improvement Program database was used to evaluate all patients who had modest levels of hypoalbuminemia (3 ≤ serum albumin < 3.5 g/dL) before colorectal resection from 2005 to 2012. Multivariate analysis using logistic regression was performed to quantify complications associated with modest hypoalbuminemia. RESULTS: A total of 108,898 patients undergoing colorectal resection were identified, of which 16,962 (15.6%) had modest levels of preoperative hypoalbuminemia. Postsurgical complications significantly associated (P < .05) with modest hypoalbuminemia were as follows: hospitalization more than 30 days (adjusted odds ratio [AOR], 1.77), deep vein thrombosis (AOR, 1.64), unplanned intubation (AOR, 1.42), ventilator dependency for more than 48 hours (AOR, 1.30), and wound disruption (AOR, 1.22). CONCLUSIONS: Modest hypoalbuminemia is a common preoperative condition in patients undergoing colorectal resection. Our analysis demonstrates that modest hypoalbuminemia has associations with increased postoperative complications, especially pulmonary complications.

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