title: Pre-operative serum albumin level substantially predicts post-operative morbidity and mortality among patients with colorectal cancer who undergo elective colectomy.
abstract: The quantitative relationship between serum albumin level and surgical outcomes has not been clearly established. This study included 3732 patients with colon cancer who underwent a potentially curative colectomy. Post-operative mortality and morbidity were analysed according to the patients' demographic data, pre-operative comorbidities, and tumour-related factors. Age, asthma, renal impairment, and albumin level were significantly associated with post-operative morbidity and mortality in the multivariate analyses. Logistic regression analysis revealed linear relationships of post-operative morbidity and mortality with albumin level. The morbidity and mortality rates decreased by 7.3% and 15.6%, respectively, for each 0.1 g/dL increase in albumin level. This finding remained significant in the hypoalbuminaemia subgroup but not in the normoalbuminaemia subgroup. That is, the morbidity and mortality rates significantly decreased by 8.7% and 17.7%, respectively (both P < 0.001), in the former group and decreased by 2.7% (P = 0.112) and 11.6% (P = 0.092), respectively, in the latter group. This study demonstrated that serum albumin level linearly predicted the post-operative morbidity and mortality among the colorectal cancer patients. Pre-operative serum albumin level may therefore be used as a continuous rather than a categorical marker of disease severity, especially among patients with hypoalbuminaemia.
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: J M
authors.initials: JM
authors.lastname: Chiang
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: C J
authors.initials: CJ
authors.lastname: Chang
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: S F
authors.initials: SF
authors.lastname: Jiang
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: C Y
authors.initials: CY
authors.lastname: Yeh
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: J F
authors.initials: JF
authors.lastname: You
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: P S
authors.initials: PS
authors.lastname: Hsieh
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: H Y
authors.initials: HY
authors.lastname: Huang
mesh_terms: D000367:Age Factors; D000368:Aged; D001249:Asthma / Q000453:epidemiology; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology* / Q000378:metabolism; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D009026:Mortality; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology* / Q000378:metabolism; D057234:Preoperative Period; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*
chemical_list: D012709:Serum Albumin
keywords: colon cancer; nutrition