Role of Preoperative Serum Albumin as Predictor of Postoperative Morbidity and Mortality in Emergency Laparotomy

Background: Malnutrition is a major risk factor for adverse outcomes in surgical patients, and serum albumin has long been considered a simple, cost-effective biomarker. This study aimed to evaluate the predictive value of preoperative serum albumin levels for postoperative morbidity and mortality in patients undergoing emergency laparotomy. Methods: A prospective cross-sectional study was conducted at RNT Medical College, Udaipur, including 105 patients undergoing emergency laparotomy. Preoperative serum albumin levels were measured and correlated with postoperative complications including wound dehiscence, sepsis, surgical site infection, prolonged ileus, anastomotic leak, and mortality. Results: Of 105 patients, 60 (57.1%) developed complications. Patients with preoperative serum albumin ≤3 g/dl had significantly higher complication rates (73.1%) compared to those with >3 g/dl (28.9%) (p<0.001). Mortality was highest in patients with albumin ≤2.5 g/dl (29.7%) versus only 2.6% when >3.5 g/dl. Wound dehiscence (29.5%) and sepsis (25.7%) were the most common complications. Low serum albumin was an independent predictor of poor outcomes. Conclusion: Preoperative hypoalbuminemia is a strong predictor of postoperative morbidity and mortality in emergency laparotomy. Serum albumin should be included in preoperative assessment to identify high-risk patients who may benefit from early nutritional optimization.