Predicting morbidity and mortality in laparoscopic cholecystectomy: Preoperative serum albumin still matters - 20/06/20
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.
Le texte complet de cet article est disponible en PDF.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. |
Keywords : Hypoalbuminemia, Cholecystectomy, Mortality, Outcomes
Plan
Vol 220 - N° 2
P. 432-437 - août 2020 Retour au numéro
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