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Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery

OBJECTIVE: To determine the relationship between preoperative hypoalbuminemia and the development of complications after gynecological cancer surgery, as well as postoperative bowel function and hospital stay. METHODS: The medical records of 533 patients with gynecological cancer surgery at Konkuk U...

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Autores principales: Kim, Jin, Shim, Seung-Hyuk, Oh, In-Kyoung, Yoon, Sang-Hee, Lee, Sun-Joo, Kim, Soo-Nyung, Kang, Soon-Beom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 2015
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588840/
https://www.ncbi.nlm.nih.gov/pubmed/26430660
http://dx.doi.org/10.5468/ogs.2015.58.5.359
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author Kim, Jin
Shim, Seung-Hyuk
Oh, In-Kyoung
Yoon, Sang-Hee
Lee, Sun-Joo
Kim, Soo-Nyung
Kang, Soon-Beom
author_facet Kim, Jin
Shim, Seung-Hyuk
Oh, In-Kyoung
Yoon, Sang-Hee
Lee, Sun-Joo
Kim, Soo-Nyung
Kang, Soon-Beom
author_sort Kim, Jin
collection PubMed
description OBJECTIVE: To determine the relationship between preoperative hypoalbuminemia and the development of complications after gynecological cancer surgery, as well as postoperative bowel function and hospital stay. METHODS: The medical records of 533 patients with gynecological cancer surgery at Konkuk University Hospital between 2005 and 2013 were reviewed. Serum albumin level <3.5 g/dL was defined as hypoalbuminemia. All perioperative complications within 30-days after surgery, time to resumption of normal diet and length of postoperative hospital stay, were analyzed. Regression models were used to assess predictors of postoperative morbidity. RESULTS: The median age was 49 years (range, 13 to 85 years). Eighty patients (15%) had hypoalbuminemia. Hypoalbuminemic patients had significantly higher consumption of alcohol >2 standard drinks per day, lower American Society of Anesthesiologist score, higher frequency of ascites, and more advanced stage compared with non-hypoalbuminemic patients. Overall complication rate within 30-days after surgery was 20.3% (108 out of 533). Hypoalbuminemic patients were more likely to develop postoperative complications compared to non-hypoalbuminemic patients (34.3% vs. 17.8%, P=0.022), and had significantly longer median time to resumption of normal diet (3.3 [1-6] vs. 2.8 [0-15] days, P=0.005) and length of postoperative hospital stay (0 [7-50] vs. 9 [1-97] days, P=0.014). In multivariate analysis, age >50 (odds ratio [OR], 2.478; 95% confidence interval [CI], 1.310 to 4.686; P=0.005), operation time (OR, 1.006; 95% CI, 1.002 to 1.009; P=0.006), and hypoalbuminemia (OR, 2.367; 95% CI, 1.021 to 5.487; P=0.044) were the significant risk factor for postoperative complications. CONCLUSION: Preoperative hypoalbuminemia in patients with elective surgery for gynecologic malignancy is an independent predictor of 30-days postoperative complications. Identification of this subset and preoperative optimization of nutritional status may improve surgical outcomes.
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spelling pubmed-45888402015-10-01 Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery Kim, Jin Shim, Seung-Hyuk Oh, In-Kyoung Yoon, Sang-Hee Lee, Sun-Joo Kim, Soo-Nyung Kang, Soon-Beom Obstet Gynecol Sci Original Article OBJECTIVE: To determine the relationship between preoperative hypoalbuminemia and the development of complications after gynecological cancer surgery, as well as postoperative bowel function and hospital stay. METHODS: The medical records of 533 patients with gynecological cancer surgery at Konkuk University Hospital between 2005 and 2013 were reviewed. Serum albumin level <3.5 g/dL was defined as hypoalbuminemia. All perioperative complications within 30-days after surgery, time to resumption of normal diet and length of postoperative hospital stay, were analyzed. Regression models were used to assess predictors of postoperative morbidity. RESULTS: The median age was 49 years (range, 13 to 85 years). Eighty patients (15%) had hypoalbuminemia. Hypoalbuminemic patients had significantly higher consumption of alcohol >2 standard drinks per day, lower American Society of Anesthesiologist score, higher frequency of ascites, and more advanced stage compared with non-hypoalbuminemic patients. Overall complication rate within 30-days after surgery was 20.3% (108 out of 533). Hypoalbuminemic patients were more likely to develop postoperative complications compared to non-hypoalbuminemic patients (34.3% vs. 17.8%, P=0.022), and had significantly longer median time to resumption of normal diet (3.3 [1-6] vs. 2.8 [0-15] days, P=0.005) and length of postoperative hospital stay (0 [7-50] vs. 9 [1-97] days, P=0.014). In multivariate analysis, age >50 (odds ratio [OR], 2.478; 95% confidence interval [CI], 1.310 to 4.686; P=0.005), operation time (OR, 1.006; 95% CI, 1.002 to 1.009; P=0.006), and hypoalbuminemia (OR, 2.367; 95% CI, 1.021 to 5.487; P=0.044) were the significant risk factor for postoperative complications. CONCLUSION: Preoperative hypoalbuminemia in patients with elective surgery for gynecologic malignancy is an independent predictor of 30-days postoperative complications. Identification of this subset and preoperative optimization of nutritional status may improve surgical outcomes. Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 2015-09 2015-09-22 /pmc/articles/PMC4588840/ /pubmed/26430660 http://dx.doi.org/10.5468/ogs.2015.58.5.359 Text en Copyright © 2015 Korean Society of Obstetrics and Gynecology http://creativecommons.org/licenses/by-nc/3.0/ Articles published in Obstet Gynecol Sci are open-access, distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Jin
Shim, Seung-Hyuk
Oh, In-Kyoung
Yoon, Sang-Hee
Lee, Sun-Joo
Kim, Soo-Nyung
Kang, Soon-Beom
Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
title Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
title_full Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
title_fullStr Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
title_full_unstemmed Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
title_short Preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
title_sort preoperative hypoalbuminemia is a risk factor for 30-day morbidity after gynecological malignancy surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588840/
https://www.ncbi.nlm.nih.gov/pubmed/26430660
http://dx.doi.org/10.5468/ogs.2015.58.5.359
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