Highlights
- •Serum albumin predicts outcomes in less invasive laparoscopic cholecystectomy.
- •There is an exponential relationship of preoperative serum albumin with mortality.
- •Hypoalbuminemia is independently associated with postoperative septic shock.
- •Our findings may preoperatively risk stratify laparoscopic cholecystectomy patients.
Abstract
Background
This study examined the association of preoperative serum albumin with outcomes for
laparoscopic cholecystectomy.
Methods
The American College of Surgeons National Surgical Quality Improvement Program was
retrospectively analyzed from 2005 to 2016 for adult patients undergoing laparoscopic
cholecystectomy. Patients were stratified into four groups: <3.0 g/dL (Severe Malnutrition), 3.0-<3.5 (Moderate Malnutrition), 3.5-<4.0 (Mild Malnutrition), and ≥4.0 g/dL (Normal Nutrition). The primary outcome of 30-day mortality was evaluated with multivariable regression.
Results
Of 131,855 patients, 14.0% had Severe, 22.8% Moderate, and 29.7% Mild Malnutrition, with 33.5% classified as Normal Nutrition. Adjusted multivariable regressions demonstrated that relative to Normal Nutrition, mortality risk was increased for Severe (OR = 3.09 [95% Confidence Interval: 2.09–4.56]) and Moderate (OR = 1.83 [1.24–2.72]) Malnutrition. Severe (OR = 2.45 [1.67–3.61]) and Moderate (OR = 1.52 [1.04–2.24]) Malnutrition were also associated with increased risk of postoperative septic shock.
Conclusions
Even in less invasive laparoscopic cholecystectomy, reduced preoperative serum albumin
is strongly associated with increased morbidity and mortality.
Keywords
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Article info
Publication history
Published online: December 05, 2019
Accepted:
December 3,
2019
Received in revised form:
November 25,
2019
Received:
March 12,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
