Pre-operative serum albumin lower than 3.73 g/L was significantly associated with a 14% increased odds of developing superficial and deep surgical site infections following Whipple surgery (OR 1.14).
Observational (n=23,808)
Yes
Does pre-operative hypoalbuminemia or elevated WBC count predict surgical site infections in patients undergoing Whipple surgery?
Pre-operative hypoalbuminemia is associated with an increased risk of superficial and deep surgical site infections, while elevated WBC count is associated with organ-space infections following Whipple surgery.
Odds Ratio: 1.14 (95% CI 1.05–1.24)
p-value: p=0.002
Whipple surgery is associated with a high risk of surgical sites infections (SSIs). Nutritional deficiency has been associated with an increased risk of wound infections. This study aims at exploring the role of preoperative albumin levels in predicting the risk of SSIs following Whipple surgery. A total of 23,808 individuals were identified from the ACS-NSQIP database from years 2011 to 2017. The primary exposure was pre-operative albumin while the secondary exposure was white blood cell (WBC) count. The primary outcome was divided into superficial and deep surgical site infections (S/D SSI) and organ-space SSI. All statistical analyses were conducted using IBM Statistical Package for Social Sciences version 26. Levels of pre-operative serum albumin less than 3.73 g/L, dirty and contaminated wounds and longer operative time were associated with increased odds for developing S/D SSIs (OR = 1.14, OR = 1.17, OR = 1.06, respectively, p-value < 0.05). Pre-operative WBC level (/L) was associated with a risk of developing an organ-space SSI but not S/D SSI (OR = 1.02, p-value 0.003). This study demonstrates the predictive role of pre-operative albumin in developing S/D SSIs and highlights the need to develop therapeutic strategies to optimize the pre-operative nutritional health status of patients undergoing Whipple surgery.
Tfaily et al. (2022) conducted an observational in Pancreatic cancer / Patients undergoing Whipple surgery (n=23,808). Pre-operative serum albumin < 3.73 g/L vs. Pre-operative serum albumin ≥ 3.73 g/L was evaluated on Superficial and deep surgical site infections (S/D SSI) within 30 days post-surgery (OR 1.14, 95% CI 1.05-1.24, p=0.002). Pre-operative serum albumin lower than 3.73 g/L was significantly associated with a 14% increased odds of developing superficial and deep surgical site infections following Whipple surgery (OR 1.14).