J Zhou1,2, N Hiki3, S Mine1, K Kumagai1, S Ida1, X Jiang1,4, S Nunobe1, M Ohashi1, T Sano1, T Yamaguchi1. 1. Department of Gastroenterological Surgery, Cancer Institute Hospital, Gastroenterological Center, Japanese Foundation for Cancer Research, Tokyo, Japan. 2. Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China. 3. Department of Gastroenterological Surgery, Cancer Institute Hospital, Gastroenterological Center, Japanese Foundation for Cancer Research, Tokyo, Japan. naoki.hiki@jfcr.or.jp. 4. Department of Gastroenterological Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Abstract
BACKGROUND: Preoperative factors, including nutritional status, may have strong correlations with postoperative morbidities. The current study evaluated preoperative prealbumin concentrations as a predictor of postoperative complications after gastric surgery. METHODS: A retrospective study of 1798 patients who underwent gastrectomy for gastric adenocarcinoma was performed. Information was collected on basic patient characteristics, preoperative laboratory findings, and 30 day postoperative complications. The patients were divided into three groups based on prealbumin concentrations (≥22 mg/dL, <22 to ≥15 mg/dL, and <15 mg/dL) for analysis. RESULTS: The overall complication rate was 21.7 %, and the infection rate was 16 %. Subgroup analysis based on prealbumin concentrations showed that complication rates were markedly elevated with decreasing concentrations of prealbumin. Multivariate analysis using a logistic regression model showed that both overall and infectious complications were strongly associated with male gender, elevated C-reactive protein (CRP), and decreased prealbumin levels (p < 0.05). Even in patients with a CRP level higher than 0.1 mg/dL, male gender and low prealbumin concentrations (<15 mg/dL) were significantly correlated with overall and infectious morbidities (p < 0.05). CONCLUSIONS: Preoperative prealbumin concentrations are useful predictors of short-term postoperative outcomes after gastrectomy.
BACKGROUND: Preoperative factors, including nutritional status, may have strong correlations with postoperative morbidities. The current study evaluated preoperative prealbumin concentrations as a predictor of postoperative complications after gastric surgery. METHODS: A retrospective study of 1798 patients who underwent gastrectomy for gastric adenocarcinoma was performed. Information was collected on basic patient characteristics, preoperative laboratory findings, and 30 day postoperative complications. The patients were divided into three groups based on prealbumin concentrations (≥22 mg/dL, <22 to ≥15 mg/dL, and <15 mg/dL) for analysis. RESULTS: The overall complication rate was 21.7 %, and the infection rate was 16 %. Subgroup analysis based on prealbumin concentrations showed that complication rates were markedly elevated with decreasing concentrations of prealbumin. Multivariate analysis using a logistic regression model showed that both overall and infectious complications were strongly associated with male gender, elevated C-reactive protein (CRP), and decreased prealbumin levels (p < 0.05). Even in patients with a CRP level higher than 0.1 mg/dL, male gender and low prealbumin concentrations (<15 mg/dL) were significantly correlated with overall and infectious morbidities (p < 0.05). CONCLUSIONS: Preoperative prealbumin concentrations are useful predictors of short-term postoperative outcomes after gastrectomy.
Authors: Ashika D Maharaj; Jennifer F Holland; Ri O Scarborough; Sue M Evans; Liane J Ioannou; Wendy Brown; Daniel G Croagh; Charles H C Pilgrim; James G Kench; Lara R Lipton; Trevor Leong; John J McNeil; Mehrdad Nikfarjam; Ahmad Aly; Paul R Burton; Paul A Cashin; Julie Chu; Cuong P Duong; Peter Evans; David Goldstein; Andrew Haydon; Michael W Hii; Brett P F Knowles; Neil D Merrett; Michael Michael; Rachel E Neale; Jennifer Philip; Ian W T Porter; Marty Smith; John Spillane; Peter P Tagkalidis; John R Zalcberg Journal: BMJ Open Date: 2019-09-30 Impact factor: 2.692