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. 2015 Sep;58(5):359-67.
doi: 10.5468/ogs.2015.58.5.359. Epub 2015 Sep 22.

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

Jin Kim  1 , Seung-Hyuk Shim  1 , In-Kyoung Oh  1 , Sang-Hee Yoon  1 , Sun-Joo Lee  1 , Soo-Nyung Kim  1 , Soon-Beom Kang  1
Affiliations

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

Jin Kim et al. Obstet Gynecol Sci. 2015 Sep.

Abstract

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.

Keywords: Genital neoplasms, female; Hypoalbuminemia; Nutritional status; Postoperative complications.

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Conflict of interest statement

Conflict of interest: No potential conflict of interest relevant to this article was reported.

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