Preoperative Serum Albumin Level as a Predictor of Operative Mortality and Morbidity

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Abstract
HYPOALBUMINEMIA has been shown to be associated with increased mortality and morbidity rates in both hospitalized patients1-4 and samples of community-dwelling elderly persons.5,6 In surgery, an association between hypoalbuminemia and adverse outcome has been recognized for many years. In an early series of 26 patients, most operated on for diseases of the digestive tract, Jones and Eaton7 found that postoperative edema was associated with low concentrations of serum albumin and serum protein, which they attributed to preoperative and postoperative undernutrition. More recently, Rich et al4 found that patients undergoing cardiac surgery who had lower serum albumin levels showed a trend toward having higher postoperative mortality rates and had significantly higher rates of several complications than did patients with higher serum albumin levels, while controlling for other risk factors. Albumin also has been found to predict postoperative mortality and morbidity for patients undergoing elective surgery8 and postoperative morbidity for those undergoing gastrointestinal tract surgery.9,10