title: Risk and predictive factors of hypoalbuminemia in cancer patients following extensive abdominal surgery despite total parenteral nutritional support.
abstract: Postoperative hypoalbuminemia is associated with adverse outcomes, particularly in cancer patients. The risk and predictors of hypoalbuminemia in cancer patients following extensive abdominal surgery (EAS), despite total parenteral nutrition (TPN) support, were evaluated. A prospective cohort study (n = 115) was conducted in patients with gastrointestinal and/or urogenital malignancies following extensive (n = 81) or moderate (n = 34) abdominal surgery (mean age ± standard deviation: 66.0 ± 11.7 years). EAS patients received daily TPN, including 200 mL of 5% human albumin solution. Serum albumin (SA) levels and hypoalbuminemia (SA < 3.5 g/dL) were assessed daily. EAS patients had an elevated risk of hypoalbuminemia during the first postoperative week [relative risk (RR): 3.12; 95% confidence interval (95% CI): 1.64-5.91]. Postoperative hypoalbuminemia was associated with surgery duration (RR: 1.76; 95% CI: 1.32-2.36), preoperative SA (RR: 0.24; 95% CI: 0.11-0.55), blood (RR: 1.46; 95% CI: 1.04-2.04) and Ringer's lactated solution (RR: 1.52; 95% CI: 1.12-2.07) volumes transfused intra-operatively. Therefore, despite TPN, cancer patients who underwent EAS had an elevated risk of postoperative hypoalbuminemia. Additional tailored nutritional support among this group is necessary to deter adverse clinical outcomes.
authors.affiliation: Department of Nutrition Science and Dietetics, Harokopio University, Athens, Greece. ecritselis@yahoo.com
authors.forename: Elena
authors.initials: E
authors.lastname: Critselis
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.forename: Anastasios
authors.initials: A
authors.lastname: Machairas
authors.forename: Antonis
authors.initials: A
authors.lastname: Zampelas
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Critselis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Polychronopoulos
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011183:Postoperative Complications / Q000097:blood; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D014565:Urogenital Neoplasms / Q000601:surgery*
chemical_list: D012709:Serum Albumin