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The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP)
While studies have demonstrated an association between preoperative hypoalbuminemia and adverse clinical outcomes, the optimal serum albumin threshold for risk-stratification in the broader surgical population remains poorly defined. We sought define the optimal threshold of preoperative serum album...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9655694/ https://www.ncbi.nlm.nih.gov/pubmed/36362771 http://dx.doi.org/10.3390/jcm11216543 |
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author | Nipper, Cole A. Lim, Kelvin Riveros, Carlos Hsu, Enshuo Ranganathan, Sanjana Xu, Jiaqiong Brooks, Michael Esnaola, Nestor Klaassen, Zachary Jerath, Angela Arrington, Amanda Wallis, Christopher J. D. Satkunasivam, Raj |
author_facet | Nipper, Cole A. Lim, Kelvin Riveros, Carlos Hsu, Enshuo Ranganathan, Sanjana Xu, Jiaqiong Brooks, Michael Esnaola, Nestor Klaassen, Zachary Jerath, Angela Arrington, Amanda Wallis, Christopher J. D. Satkunasivam, Raj |
author_sort | Nipper, Cole A. |
collection | PubMed |
description | While studies have demonstrated an association between preoperative hypoalbuminemia and adverse clinical outcomes, the optimal serum albumin threshold for risk-stratification in the broader surgical population remains poorly defined. We sought define the optimal threshold of preoperative serum albumin concentration for risk-stratification of adverse post-operative outcomes. Using the American College of Surgeons National Surgical Quality Improvement Program Database, we identified 842,672 patients that had undergone a common surgical procedure in one of eight surgical specialties. An optimal serum albumin concentration threshold for risk-stratification was determined using receiver-operating characteristic analysis. Multivariable logistic regression analysis was used to evaluate the odds of adverse surgical events; a priori defined subgroup analyses were performed. A serum albumin threshold of 3.4 g/dL optimally predicted adverse surgical outcomes in the broader cohort. After multivariable analysis, patients with hypoalbuminemia had increased odds of death within 30 days of surgery (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.94–2.08). Hypoalbuminemia was associated with greater odds of primary adverse events among patients with disseminated cancer (OR 2.03, 95% CI 1.88–2.20) compared to patients without disseminated cancer (OR 1.47, 95% CI 1.44–1.51). The standard clinical threshold for hypoalbuminemia is the optimal threshold for preoperative risk assessment. |
format | Online Article Text |
id | pubmed-9655694 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96556942022-11-15 The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP) Nipper, Cole A. Lim, Kelvin Riveros, Carlos Hsu, Enshuo Ranganathan, Sanjana Xu, Jiaqiong Brooks, Michael Esnaola, Nestor Klaassen, Zachary Jerath, Angela Arrington, Amanda Wallis, Christopher J. D. Satkunasivam, Raj J Clin Med Article While studies have demonstrated an association between preoperative hypoalbuminemia and adverse clinical outcomes, the optimal serum albumin threshold for risk-stratification in the broader surgical population remains poorly defined. We sought define the optimal threshold of preoperative serum albumin concentration for risk-stratification of adverse post-operative outcomes. Using the American College of Surgeons National Surgical Quality Improvement Program Database, we identified 842,672 patients that had undergone a common surgical procedure in one of eight surgical specialties. An optimal serum albumin concentration threshold for risk-stratification was determined using receiver-operating characteristic analysis. Multivariable logistic regression analysis was used to evaluate the odds of adverse surgical events; a priori defined subgroup analyses were performed. A serum albumin threshold of 3.4 g/dL optimally predicted adverse surgical outcomes in the broader cohort. After multivariable analysis, patients with hypoalbuminemia had increased odds of death within 30 days of surgery (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.94–2.08). Hypoalbuminemia was associated with greater odds of primary adverse events among patients with disseminated cancer (OR 2.03, 95% CI 1.88–2.20) compared to patients without disseminated cancer (OR 1.47, 95% CI 1.44–1.51). The standard clinical threshold for hypoalbuminemia is the optimal threshold for preoperative risk assessment. MDPI 2022-11-04 /pmc/articles/PMC9655694/ /pubmed/36362771 http://dx.doi.org/10.3390/jcm11216543 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Nipper, Cole A. Lim, Kelvin Riveros, Carlos Hsu, Enshuo Ranganathan, Sanjana Xu, Jiaqiong Brooks, Michael Esnaola, Nestor Klaassen, Zachary Jerath, Angela Arrington, Amanda Wallis, Christopher J. D. Satkunasivam, Raj The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP) |
title | The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP) |
title_full | The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP) |
title_fullStr | The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP) |
title_full_unstemmed | The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP) |
title_short | The Association between Serum Albumin and Post-Operative Outcomes among Patients Undergoing Common Surgical Procedures: An Analysis of a Multi-Specialty Surgical Cohort from the National Surgical Quality Improvement Program (NSQIP) |
title_sort | association between serum albumin and post-operative outcomes among patients undergoing common surgical procedures: an analysis of a multi-specialty surgical cohort from the national surgical quality improvement program (nsqip) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9655694/ https://www.ncbi.nlm.nih.gov/pubmed/36362771 http://dx.doi.org/10.3390/jcm11216543 |
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