Prognostic significance of preoperative serum albumin level in patients undergoing emergency laparotomy in University of Benin Teaching Hospital, Benin, Nigeria

Introduction: Preoperative serum albumin level has prognostic value which may aid appropriate risk stratification and planning of the perioperative and postoperative care of patients that undergo emergency laparotomy. This study is aimed at evaluating the prognostic value of preoperative serum albumin level in predicting 30-day postoperative mortality and morbidity in patients that had laparotomy for acute abdomen.

Methods: An observational study was conducted over 12 months at University of Benin Teaching Hospital. Eighty-seven patients that had emergency laparotomy were recruited. Preoperative serum albumin levels were measured. Patients were followed up for 30 days postoperatively, taking note of complications, mortality and duration of admission. Data was analysed using SPSS version 22.0. Fischer’s exact test and multivariate analysis were used to determine association between variables. Statistical significance was set at p-values less than 0.05.

Results: Eighty-seven adults were studied, 61 (70.1%) males and 26 (29.9%) females. Thirty-one (35.6%) patients developed at least one complication. The most common complication was surgical site infection. Hypoalbuminemic patients had more complications, higher mortality and had more prolonged admission than patients that had normal preoperative albumin levels: (40% vs 17%, 18.8% vs 5.9%, and 31.4% vs 17.6% respectively). Hypoalbuminemia was associated with development of surgical site infection (p=0.006) and burst abdomen (p=0.032).

Conclusion: This study demonstrated that preoperative serum albumin level can be used to prognosticate 30 days postoperative outcome of emergency laparotomies.

Leave a Reply