title: Prealbumin levels as a useful marker for predicting infectious complications after gastric surgery.
abstract: OBJECTIVE
  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/m(2)), 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.
authors: Nutrition Support Team, Seoul National University Hospital, Seoul, South Korea.
authors: Hye-Jung
authors: HJ
authors: Bae
authors: Hyuk-Joon
authors: HJ
authors: Lee
authors: Dong-Seok
authors: DS
authors: Han
authors: Yun-Suhk
authors: YS
authors: Suh
authors: Yong-Hwa
authors: YH
authors: Lee
authors: Hye-Suk
authors: HS
authors: Lee
authors: Jae-Jin
authors: JJ
authors: Cho
authors: Seong-Ho
authors: SH
authors: Kong
authors: Han-Kwang
authors: HK
authors: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D015992:Body Mass Index; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D011228:Prealbumin / Q000378:metabolism*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D056910:Republic of Korea; D012709:Serum Albumin / Q000378:metabolism; D013272:Stomach Diseases / Q000097:blood / Q000601:surgery*
chemical_list: D015415:Biomarkers; D011228:Prealbumin; D012709:Serum Albumin