title: Impact of Preoperative Prealbumin on Outcomes After Cardiac Surgery.
abstract: BACKGROUND
  Preoperative malnutrition is increasingly prevalent in patients undergoing cardiac surgery. Although prealbumin is a widely used indicator of nutrition status, its use in the preoperative assessment of patients undergoing cardiac surgery is not well defined. The purpose of this study is to determine the impact of preoperative prealbumin levels on outcomes after cardiac surgery.
  
  
  METHODS
  Data were prospectively gathered from February 2013 to July 2013 on 69 patients undergoing cardiac surgery. Prealbumin levels were obtained within 24 hours of surgery. Patients were divided into 2 groups based on a prealbumin cutoff value of 20 mg/dL.
  
  
  RESULTS
  Of the 69 patients, 32 (46.4%) had a preoperative prealbumin ≤ 20 mg/dL. There was no correlation between prealbumin levels and body mass index (r = -0.13, P = .28). Likewise, there was no correlation between preoperative albumin and prealbumin levels (r = 0.09, P = .44). Nine of 32 (28.1%) patients with low preoperative prealbumin levels had postoperative infections compared with 2 of 37 (5.4%) patients with high prealbumin levels (P = .010). Patients with low prealbumin levels also had increased risk of postoperative intubation for > 12 hours (P = .010).
  
  
  CONCLUSIONS
  Patients undergoing cardiac surgery with preoperative prealbumin levels of ≤ 20 mg/dL have an increased risk for postoperative infections and the need for longer mechanical ventilation. If feasible, nutrition optimization of such patients may be considered prior to cardiac surgery.
authors.affiliation: North Shore University Hospital, Manhasset, New York pyu2@nshs.edu.
authors.forename: Pey-Jen
authors.initials: PJ
authors.lastname: Yu
authors.affiliation: North Shore University Hospital, Manhasset, New York.
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Cassiere
authors.affiliation: North Shore University Hospital, Manhasset, New York.
authors.forename: Sophia L
authors.initials: SL
authors.lastname: Dellis
authors.affiliation: North Shore University Hospital, Manhasset, New York.
authors.forename: Frank
authors.initials: F
authors.lastname: Manetta
authors.affiliation: The Feinstein Institute for Medical Research, Manhasset, New York.
authors.forename: Nina
authors.initials: N
authors.lastname: Kohn
authors.affiliation: North Shore University Hospital, Manhasset, New York.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Hartman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control; D011228:Prealbumin / Q000008:administration & dosage* / Q000378:metabolism; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012121:Respiration, Artificial; D012307:Risk Factors
chemical_list: D011228:Prealbumin
keywords: cardiac disease; enteral nutrition; nutrition; nutrition assessment; research and diseases