Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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
_version_ 1784829249157332992
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
work_keys_str_mv AT nippercolea theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT limkelvin theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT riveroscarlos theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT hsuenshuo theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT ranganathansanjana theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT xujiaqiong theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT brooksmichael theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT esnaolanestor theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT klaassenzachary theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT jerathangela theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT arringtonamanda theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT wallischristopherjd theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT satkunasivamraj theassociationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT nippercolea associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT limkelvin associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT riveroscarlos associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT hsuenshuo associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT ranganathansanjana associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT xujiaqiong associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT brooksmichael associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT esnaolanestor associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT klaassenzachary associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT jerathangela associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT arringtonamanda associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT wallischristopherjd associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip
AT satkunasivamraj associationbetweenserumalbuminandpostoperativeoutcomesamongpatientsundergoingcommonsurgicalproceduresananalysisofamultispecialtysurgicalcohortfromthenationalsurgicalqualityimprovementprogramnsqip