title: Postoperative hypoalbuminemia is associated with outcome in patients undergoing off-pump coronary artery bypass graft surgery.
abstract: OBJECTIVE
  The authors aimed to investigate whether immediate postoperative hypoalbuminemia could be associated with outcomes after off-pump coronary artery bypass graft (OPCAB) surgery.
  
  
  METHODS
  A retrospective analysis of the medical data.
  
  
  METHODS
  Cardiac operating room and adult cardiovascular intensive care unit at a single institution.
  
  
  METHODS
  Six hundred ninety adult patients underwent elective OPCAB surgery over a 30-month period.
  
  
  METHODS
  None.
  
  
  RESULTS
  To evaluate the clinical relevance of immediate postoperative hypoalbuminemia, the lowest serum albumin level measured over the first 12 hours postoperatively was recorded. A cutoff point was calculated by the area under the curve in the receiver operating characteristic plot for 30-day adverse events including death. Patients were classified according to the cutoff value, and outcomes were compared between groups using propensity score-matching analysis. The impact of immediate postoperative hypoalbuminemia on OPCAB outcome was investigated using multivariate analysis. The cutoff value for immediate postoperative albumin concentration for predicting 30-day adverse events was 2.3 g/dL. Immediate postoperative hypoalbuminemia (<2.3 g/dL) was associated independently with postoperative respiratory failure (odds ratio [OR] = 8.85, p = 0.04), wound infection (OR = 4.44, p = 0.04), the need for an intra-aortic balloon pump after the operation (OR = 13.7, p = 0.02), renal failure (OR = 7.98, p = 0.01), reoperation for bleeding (OR = 4.33, p = 0.05), and the need for inotropes in the intensive care unit (OR = 1.79, p = 0.02).
  
  
  CONCLUSIONS
  Immediate postoperative hypoalbuminemia was associated with poorer outcomes in OPCAB patients. Monitoring of albumin levels after OPCAB could identify patients at risk for short-term adverse events.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
authors.forename: Eun-Ho
authors.initials: EH
authors.lastname: Lee
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Chin
authors.forename: Dae-Kee
authors.initials: DK
authors.lastname: Choi
authors.forename: Bo-Young
authors.initials: BY
authors.lastname: Hwang
authors.forename: Suk-Jung
authors.initials: SJ
authors.lastname: Choo
authors.forename: Jun-Gol
authors.initials: JG
authors.lastname: Song
authors.forename: Tae-Yop
authors.initials: TY
authors.lastname: Kim
authors.forename: In-Cheol
authors.initials: IC
authors.lastname: Choi
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality*; D012189:Retrospective Studies; D016896:Treatment Outcome