PREOPERATIVE SERUM ALBUMIN LEVEL AS A PREDICTOR OF SURGICAL SITE INFECTION IN ELECTIVE SURGERY FOR GASTROINTESTINAL MALIGNANCY
Das Prasad Gajendra*, Siwakoti Yahun Chandra and Das Anamika
ABSTRACT
Background: Surgical site infection (SSI) has a direct negative influence on patient outcome. To date, there are relatively few studies examining the influence of a patient’s preoperative nutritional status (especially serum albumin) on the development of SSI. This study was aimed to identify demography of GI malignant cases operated in elective basis in gastrosurgery unit of Bir Hospital, study the rate of SSI in relation with preoperative serum albumin level, study relation between preoperative serum albumin level and length of post-op hospital stay. Methods: A prospective observational hospital based study performed at Bir Hospital, Mahaboudha Kathmandu during December 2015 to November 2016 over 56 cases who operated in elective basis for gastrointestinal malignancy. Patients were divided according to their serum albumin level into two groups. Group I: with serum albumin ≤3.5 gm/dl and Group II: with serum albumin >3.5 gm/dl. Postoperatively patients were observed for development of surgical site infection and length of hospital stay. Results: Postoperative surgical site infection was higher in number and percentage in group I (serum albumin ≤ 3.5 gm/dl) compared to group II (serum albumin > 3.5 gm/dl) with P-value 0.028. There was significant correlation between preoperative hypoalbuminemia and development of postoperative surgical site infection. Furthermore, the length of postoperative hospital stay was significantly longer in group I (serum albumin ≤ 3.5 gm/dl) (11.16±3.37 days) compared to group II (serum albumin > 3.5 gm/dl) (8.60±2.08 days) (P=0.002). Conclusions: The current study revealed that preoperative hypoalbuminemia is a predictor of development of postoperative surgical site infection and increases the length of postoperative hospital stay following surgery for gastrointestinal malignancy.
Keywords: Surgical site infection, Serum albumin, Gastro-intestinal malignancy, length of hospital stay.
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