A Study of Role of Preoperative Albumin Levels and Postoperative Drop in the Prediction of Outcomes of Exploratory Laparotomy.

Background: Serum albumin is generally considered to be a predictor of a patient's nutritional status. Hypoalbuminemia is associated with increased mortality and morbidity in postoperative patients. In this study, we used preoperative serum albumin levels and a drop in postoperative albumin levels to assess various postexploratory laparotomy complications.

Aim: This study aims to evaluate the role of preoperative albumin levels and their postoperative drop in the incidence and severity of outcomes in exploratory laparotomies.

Study Design: Prospective observational.

Materials And Methods: Preoperative and postoperative serum albumin level was observed in 52 patients who underwent exploratory laparotomy for various pathological conditions and were divided into ten groups based on the specific outcomes observed, such as surgical site infections (SSIs), delayed wound healing (DWH), or acute respiratory distress syndrome. Within each group, the relationship between the preoperative albumin levels, their postoperative drop, and the severity of the outcomes was analyzed. The study was conducted over a period from August 2022 to July 2024.

Results: Among ten outcomes, four outcomes showed significant results. Patients with SSI and DWH showed significant differences in drop-in postoperative albumin levels (P = 0.005), with a mean difference of 0.64810 g/dL. Among anastomotic leak (AL) patients, Out of 52 patients who underwent exploratory laparotomy due to various indications, only 32 had bowel anastomosis, with significant value for AL when equal variances are assumed (P = 0.039) noted. In the mortality category, for preoperative albumin, there is a significant mean difference of 1.2970 (P = 0.001), with higher levels in survivors compared to nonsurvivors. Similarly, postoperative albumin levels show a significant mean difference of 1.18085 (P = 0.002), again favoring survivors.

Conclusion: Preoperative hypoalbuminemia <3.0 g/dl is a strong and independent risk factor for postoperative morbidity and mortality in gastrointestinal surgeries. Preoperative improvement of nutritional status must be done before undertaking surgery.