Prediction of postoperative morbidity and mortality in emergency abdominal surgeries using factors like serum albumin and BMI: A prospective study

Abstract

Introduction: Wound healing is a catabolic process, and it requires energy. Patients who are severely malnourished demonstrates impaired wound healing and predisposition to infection. They also suffer deficient immune mechanisms. The degree of malnutrition is estimated based on weight loss during the past 6 months, physical findings, and plasma protein assessment. The purpose of this study aimed to investigate serum albumin and BMI as predictors of postoperative morbidity and mortality. Materials and Methods: A total of 99 patients more than 18 years of age with serum albumin level less than 3g/dl, posted for emergency and elective laparotomy for GI disease were included in this study. The following assessments were done, preoperative evaluation of serum albumin, nutritional assessment (Mid upper arm thickness, skin fold thickness) along with body mass index (BMI) and post operative evaluation of serum albumin after 48 hours and 7 days. Early and late (30 days) post operative complications were studied. Results: Maximum number of patients was in the age group of 40-59 years and 59 patients (59.60%) developed post operative complications. Surgical site infection (SSI) is seen in majority (32.32%) of the patients as early post operative complication and wound dehiscence was the most common late complication (9.09%). Most of the early post operative complications are present in patient with serum albumin level of 2.1 to 2.7 g/dl (43.43%). The relation between preoperative serum albumin and early, late post operative complications were statistically significant. There was significant corelation between age, BMI and complications. There were four deaths in the study. Conclusion: Preoperative hypoalbuminemia