Role of Serum Albumin as Predictor of Postoperative Morbidity and Mortality in Gastrointestinal Surgeries

Serum albumin, a key protein in human plasma, maintains oncotic pressure and transports various substances. In gastrointestinal surgeries, the impact of low preoperative serum albumin on postoperative morbidity and mortality is significant but not fully understood. Objective: To determine the role of serum albumin levels as a predictor of postoperative morbidity and mortality in patients undergoing gastrointestinal surgeries. Methods: This prospective cohort study was conducted at Department of Surgery – Jinnah Post Graduate Medical Centre, Karachi from January 01, 2021, to December 31, 2021. The study included 86 patients with age range 18 to 45 years and of either gender who had undergone elective gastrointestinal surgeries and had preoperative serum albumin levels measured within 7 days before the surgery. Patients having exploratory laparotomy involving organs other than GIT, those who lost to follow-up and patients with conditions that significantly affect serum albumin levels, such as chronic liver disease or nephrotic syndrome, were excluded from the study. Results: Hypoalbuminemia (<3.5 mg/dL) was observed in 61 patients (70.9%), while 25 patients (29.1%) had normal albumin levels (>3.5 mg/dL). All 30-day mortalities occurred in the hypoalbuminemia group (p < 0.05). Superficial surgical site infections were significantly higher in the hypoalbuminemia group as well (73.4% vs. 26.6%, p < 0.05). Other complications were more frequent in patients with hypoalbuminemia but were not statistically significant (p > 0.05). Conclusions: The study findings indicate that preoperative serum albumin levels were a significant predictor of postoperative complications in patients undergoing elective gastrointestinal surgeries