title: Even modest hypoalbuminemia affects outcomes of colorectal surgery patients.
abstract: BACKGROUND
  A small decrease in the serum albumin from the normal level is a common condition in preoperative laboratory tests of colorectal surgery patients; however, there is limited data examining these patients. We sought to identify outcomes of such patients.
  
  
  METHODS
  The National Surgical Quality Improvement Program database was used to evaluate all patients who had modest levels of hypoalbuminemia (3 ≤ serum albumin < 3.5 g/dL) before colorectal resection from 2005 to 2012. Multivariate analysis using logistic regression was performed to quantify complications associated with modest hypoalbuminemia.
  
  
  RESULTS
  A total of 108,898 patients undergoing colorectal resection were identified, of which 16,962 (15.6%) had modest levels of preoperative hypoalbuminemia. Postsurgical complications significantly associated (P < .05) with modest hypoalbuminemia were as follows: hospitalization more than 30 days (adjusted odds ratio [AOR], 1.77), deep vein thrombosis (AOR, 1.64), unplanned intubation (AOR, 1.42), ventilator dependency for more than 48 hours (AOR, 1.30), and wound disruption (AOR, 1.22).
  
  
  CONCLUSIONS
  Modest hypoalbuminemia is a common preoperative condition in patients undergoing colorectal resection. Our analysis demonstrates that modest hypoalbuminemia has associations with increased postoperative complications, especially pulmonary complications.
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA.
authors.forename: Zhobin
authors.initials: Z
authors.lastname: Moghadamyeghaneh
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA.
authors.forename: Grace
authors.initials: G
authors.lastname: Hwang
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Hanna
authors.affiliation: Department of Statistics, University of California, Irvine, CA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Phelan
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Carmichael
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Mills
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA.
authors.forename: Alessio
authors.initials: A
authors.lastname: Pigazzi
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Dolich
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard, West Suite 1600, Orange, CA, USA. Electronic address: mstamos@uci.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D000368:Aged; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D057234:Preoperative Period; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Colorectal surgery; Hypoalbuminemia; Surgical complications