Preoperative Serum Albumin and Body Mass Index as Predictors of PostOperative Morbidity and Mortality in Elective Major General Surgerie

Author(s): Vaibhavkant Baderiya, Vikash Kumar, Nisith Ranjan Malik

BACKGROUND Hippocrates recognized the side effects of malnutrition on the morbidity and mortality of patients. The most clinically useful parameter is serum albumin. It predicts perioperative morbidity and mortality. The main objective was to study the preoperative serum albumin and Body Mass Index as predictors of postoperative morbidity and mortality in elective major general surgeries. METHODS The study was conducted on 50 patients who underwent elective surgery at Calcutta National Medical College and Hospital, Kolkata between March 2013-Feb 2014. Z- Test and Fischer exact t-test were used for statistical analysis. Preoperative and post-operative parameters were taken. Preoperative parametersserum albumin level and body mass index. Post-operative parameters- morbidity and mortality. Permission from institutional ethics committee was obtained. RESULTS Out of 50 patients studied 18 (36%) were malignant and 32 (64%) were nonmalignant. 20 patients developed complications, 4 (20%) were malignant and 16 (80%) were non-malignant. Among the patients with malignancy (18) only 4 had complications, of which 2 (11%) were <3.0 g/dl and 2 (11%) between 3.1- 3.5 g/dl. Albumin less than 2.5 g/dl (p<0.001) and BMI less than 20 Kg/m2 (p<0.005) and greater than 30 Kg/m2 (p <0.005) was associated with increase in postoperative complications. CONCLUSIONS The correlation between the serum albumin and complication rate was statistically significant in the malignant diseases when considered separately. Serum albumin < 3.0 g/dl was associated with increased post-operative morbidity and mortality.