title: Serum albumin is an early predictor of complications after liver surgery.
abstract: BACKGROUND
  The morbidity associated with liver surgery remained substantially high despite considerable surgical and anesthetic improvements. The unmet need of accurate biomarkers to predict postoperative complications is widely accepted.
  
  
  OBJECTIVE
  This pilot study aimed to assess serum albumin as a surrogate marker of surgical stress and to test its potential predictive role for postoperative complications.
  
  
  METHODS
  This retrospective pilot study included 106 patients who underwent liver surgery between 2010 and 2014. Serum albumin levels were measured pre- and post-operatively. Maximal albumin decrease (AlbΔmin) was correlated with complications.
  
  
  RESULTS
  Serum albumin rapidly dropped after surgery. AlbΔmin was significantly increased in patients with complications (14.5±6.0g/L vs. 10.3±7.2, p=0.009). On multivariate analysis, ASA III/IV (p=0.016) and AlbΔmin (p=0.037) were the only predictors of overall complications.
  
  
  CONCLUSIONS
  Early postoperative drop of serum albumin reflects the intensity of the surgical stress and may predict complications after liver surgery. Serum albumin is a biomarker displaying precious features and deserving further prospective investigations.
authors.affiliation: Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Ismail
authors.initials: I
authors.lastname: Labgaa
authors.affiliation: Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Gaëtan-Romain
authors.initials: GR
authors.lastname: Joliat
authors.affiliation: Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Switzerland. Electronic address: demartines@chuv.ch.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Demartines
authors.affiliation: Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Hübner
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000097:blood*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D013312:Stress, Physiological
chemical_list: D015415:Biomarkers; D012709:Serum Albumin
keywords: Biomarker; Liver surgery; Postoperative complications; Serum albumin