Publication:

A study to evaluate post operative drop in serum albumin level as marker for surgical stress and predictor for clinical outcome in laparotomy patients

Background Surgical involvements trigger metabolic stress responses of different magnitude, contributing to delayed recovery, complication rate and length of hospital stay. Insulin resistance, serum albumin levels, cytokines such as interleukin-6, interleukin-10, and other cytokines are used in clinical studies as measure for surgical stress. Clinical practitioners routinely measure C-reactive protein (CRP) levels in the blood after surgery to assess postoperative inflammation and predict the likelihood of postsurgical side effects. The slow kinetics of CRP, which makes it a poor predictor of stress-related complications, is a significant drawback. Albumin is widely used as nutritional marker and predictor. It shows an immediate response to surgical stress and could therefore qualify to measure surgical stress and to predict a complicated postoperative course. The aim of the present study was therefore to evaluate post-operative drop in serum albumin as a marker for surgical stress and predictor for clinical outcome in laparotomy patients.

Methods Patients admitted under surgical units from December 2020 to June 2022, at Mamata Medical College and Hospital, Khammam. A study was carried out on 50 patients admitted, undergoing Laparotomy electively and Emergency. All these patients have been assessed both preoperatively and postoperatively and their complications have been documented.

Results Serum albumin levels were compared pre-operatively and postoperatively using analysis of variance (ANOVA) test. There is statistical significance between pre-operative serum albumin levels and postoperative serum albumin levels from post-operative day (POD) 1 to POD 5.

Conclusions The serum albumin measurement is simple, cost effective and easy to perform. Using the serum albumin as a marker, reliable predictions can be made regarding the surgical complications, duration of stay in the hospital and the severity of surgical stress.