Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study

Background. Surgical stress during major surgery may be related to adverse clinical outcomes and early quantification of stress response would be useful to allow prompt interventions. The aim of this study was to evaluate the acute phase protein albumin in the context of the postoperative stress res...

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Main Authors: Martin Hübner, Styliani Mantziari, Nicolas Demartines, François Pralong, Pauline Coti-Bertrand, Markus Schäfer
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2016/8743187
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author Martin Hübner
Styliani Mantziari
Nicolas Demartines
François Pralong
Pauline Coti-Bertrand
Markus Schäfer
author_facet Martin Hübner
Styliani Mantziari
Nicolas Demartines
François Pralong
Pauline Coti-Bertrand
Markus Schäfer
author_sort Martin Hübner
collection DOAJ
description Background. Surgical stress during major surgery may be related to adverse clinical outcomes and early quantification of stress response would be useful to allow prompt interventions. The aim of this study was to evaluate the acute phase protein albumin in the context of the postoperative stress response. Methods. This prospective pilot study included 70 patients undergoing frequent abdominal procedures of different magnitude. Albumin (Alb) and C-reactive protein (CRP) levels were measured once daily starting the day before surgery until postoperative day (POD) 5. Maximal Alb decrease (Alb Δ min) was correlated with clinical parameters of surgical stress, postoperative complications, and length of stay. Results. Albumin values dropped immediately after surgery by about 10 g/L (42.2±4.5 g/L preoperatively versus 33.8±5.3 g/L at day 1, P<0.001). Alb Δ min was correlated with operation length (Pearson ρ=0.470, P<0.001), estimated blood loss (ρ=0.605, P<0.001), and maximal CRP values (ρ=0.391, P=0.002). Alb Δ min levels were significantly higher in patients having complications (10.0±5.4 versus 6.1±5.2, P=0.005) and a longer hospital stay (ρ=0.285, P<0.020). Conclusion. Early postoperative albumin drop appeared to reflect the magnitude of surgical trauma and was correlated with adverse clinical outcomes. Its promising role as early marker for stress response deserves further prospective evaluation.
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spelling doaj-art-e8bcdccdeaac4ea8b1f75eb379a412252025-02-03T06:11:36ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/87431878743187Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot StudyMartin Hübner0Styliani Mantziari1Nicolas Demartines2François Pralong3Pauline Coti-Bertrand4Markus Schäfer5Department of Visceral Surgery and Transplantation and Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery and Transplantation and Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery and Transplantation and Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery and Transplantation and Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery and Transplantation and Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Visceral Surgery and Transplantation and Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, SwitzerlandBackground. Surgical stress during major surgery may be related to adverse clinical outcomes and early quantification of stress response would be useful to allow prompt interventions. The aim of this study was to evaluate the acute phase protein albumin in the context of the postoperative stress response. Methods. This prospective pilot study included 70 patients undergoing frequent abdominal procedures of different magnitude. Albumin (Alb) and C-reactive protein (CRP) levels were measured once daily starting the day before surgery until postoperative day (POD) 5. Maximal Alb decrease (Alb Δ min) was correlated with clinical parameters of surgical stress, postoperative complications, and length of stay. Results. Albumin values dropped immediately after surgery by about 10 g/L (42.2±4.5 g/L preoperatively versus 33.8±5.3 g/L at day 1, P<0.001). Alb Δ min was correlated with operation length (Pearson ρ=0.470, P<0.001), estimated blood loss (ρ=0.605, P<0.001), and maximal CRP values (ρ=0.391, P=0.002). Alb Δ min levels were significantly higher in patients having complications (10.0±5.4 versus 6.1±5.2, P=0.005) and a longer hospital stay (ρ=0.285, P<0.020). Conclusion. Early postoperative albumin drop appeared to reflect the magnitude of surgical trauma and was correlated with adverse clinical outcomes. Its promising role as early marker for stress response deserves further prospective evaluation.http://dx.doi.org/10.1155/2016/8743187
spellingShingle Martin Hübner
Styliani Mantziari
Nicolas Demartines
François Pralong
Pauline Coti-Bertrand
Markus Schäfer
Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study
Gastroenterology Research and Practice
title Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study
title_full Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study
title_fullStr Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study
title_full_unstemmed Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study
title_short Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study
title_sort postoperative albumin drop is a marker for surgical stress and a predictor for clinical outcome a pilot study
url http://dx.doi.org/10.1155/2016/8743187
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