A study of serum albumin as an indicator for complications in patients undergoing abdominal surgery

Introduction: Albumin is the major protein of human plasma produced by the liver and is conversely, downregulated by inflammatory signals. It is widely used as a nutritional marker and shows immediate response to surgical stress and could therefore qualify to measure surgical stress and to predict a complicated postoperative course. Aims and Objects: To study the level of acute phase protein albumin as an indicator for adverse outcome/morbidity in patients undergoing abdominal surgeries. Materials and Methods: A total of 121 patients undergoing abdominal surgery in the Department of General Surgery, Regional Institute of Medical Sciences, Imphal from August 2019 to July 2021 were included in this study. Patients who are immunosuppressed, pregnant, and those <18 years and >65 years were excluded. Results: There was a significant difference in the reduction in albumin level from pre- to postoperative day 5 among the three groups (no complications, Clavien–Dindo Grade I and Clavien–Dindo Grade II and above). There was a significant difference between those with no complication group with either Grade I or Grade II and above groups. Conclusion: Lower preoperative albumin level usually results in higher complication rate, and longer hospital stay. Out of those having postoperative complications, majority (52.1%) had Grade I complications. The most common complication was surgical site infection which was successfully managed conservatively.