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Prealbumin Levels as a Useful Marker for Predicting Infectious Complications After Gastric Surgery

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background/Objectives

Preoperative nutritional status is associated with postoperative complications. Prealbumin, a visceral protein, is sensitive to protein malnutrition. The objective of this study is to evaluate the role of preoperative prealbumin levels as a marker for predicting complications after gastric surgery.

Methods

An observational study was performed on 183 patients who underwent gastric surgery due to benign or malignant gastric disease at Seoul National University Hospital (SNUH) between August 2009 and October 2010. Preoperative prealbumin levels were also measured. Nutritional variables such as prealbumin (cutoff value, 18 mg/dL), albumin, body mass index (BMI), and clinicopathologic data were collected. Postoperative hospital stay, 30-day complications and mortality rate were obtained to investigate outcomes.

Results

The complication rate was 52% in the abnormal prealbumin group (n = 23) and 24% in the normal prealbumin group (n = 160; p = 0.005). The complication rate was higher in patients with low preoperative albumin levels (<3.5 g/dL) and abnormal BMI (<18.5 kg/m2), but the differences were not statistically significant. Comorbidity of diabetes mellitus (DM), resection extent, combined resection, TNM stage and prealbumin levels were associated with complications. In multivariate analysis, DM and combined resection were significantly correlated with complications (p = 0.001 for each). In subgroup analysis, resection extent, approach, combined resection, TNM stage, and prealbumin levels were significantly associated with infectious complications. Multivariate analysis identified combined resection (p = 0.001) and prealbumin levels (p = 0.032) as independent variables.

Conclusions

Preoperative prealbumin levels could be a useful marker for predicting complications, especially infectious complications, after gastric surgery.

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Abbreviations

SNUH:

Seoul National University Hospital

BMI:

Body mass index

DM:

Diabetes mellitus

VA:

Veterans Affairs

SGA:

Subjective global assessment

DNA:

Detailed nutrition assessment

NRS:

Nutrition risk screening

UICC/AJCC:

Union for International Cancer Control/American Joint Cancer Committee

STG:

Subtotal gastrectomy

TG:

Total gastrectomy

LADG:

Laparoscopy-assisted distal gastrectomy

CT:

Computed tomography

PCD:

Percutaneous drainage

UGIS:

Upper gastrointestinal series

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Disclosure

All authors have no conflict of interest.

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Authors and Affiliations

  1. Nutrition Support Team, Seoul National University Hospital, Seoul, South Korea

    Hye-Jung Bae, Hyuk-Joon Lee, Dong-Seok Han, Yun-Suhk Suh, Yong-Hwa Lee, Hye-Suk Lee, Jae-Jin Cho, Seong-Ho Kong & Han-Kwang Yang

  2. Department of Pharmacy, Seoul National University Hospital, Seoul, South Korea

    Hye-Jung Bae, Yong-Hwa Lee & Hye-Suk Lee

  3. Division of Gastrointestinal Surgery, Seoul National University Hospital, Seoul, South Korea

    Hyuk-Joon Lee, Dong-Seok Han, Yun-Suhk Suh, Seong-Ho Kong & Han-Kwang Yang

  4. Department of Surgery and Cancer Research Institute, College of Medicine, Seoul National University, 101 Daehak-ro Jongno-gu, Seoul, 110-744, South Korea

    Hyuk-Joon Lee & Han-Kwang Yang

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  1. Hye-Jung Bae
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Correspondence to Hyuk-Joon Lee.

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Bae, HJ., Lee, HJ., Han, DS. et al. Prealbumin Levels as a Useful Marker for Predicting Infectious Complications After Gastric Surgery. J Gastrointest Surg 15, 2136–2144 (2011). https://doi.org/10.1007/s11605-011-1719-z

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  • DOI: https://doi.org/10.1007/s11605-011-1719-z

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