Pre-operative Serum Albumin as a Predictor of Adverse Outcomes in Open Abdominal Surgery: A Retrospective Study in Central Queensland

Purpose Hypoalbuminemia, which is indicative of protein-energy malnutrition, is linked to increased morbidity and mortality in acute surgical patients due to increased catabolism. This study evaluates the relationship between preoperative serum albumin levels and postoperative morbidity and mortality in patients who underwent open abdominal surgery. Methodology We used the Operating Room Management Information System (ORMIS) and coding to retrospectively find a complete list of surgeries from January 2021 to June 2023 using the term "laparotomy" and "open surgery". Patient demographics, comorbidities, pre-operative serum albumin, laboratory parameters, surgical category, postoperative complications, length of hospital stay, and death up to postoperative day 30 were collected. Serum albumin less than 35g/L is considered as hypoalbuminemia in this study. Results A total of 182 patients were analyzed, with 101 having hypoalbuminemia (serum albumin<35 g/L) and 81 having normal albumin levels (serum albumin≥35 g/L). Patients with hypoalbuminemia had significantly lower haemoglobin levels (126 g/L vs. 142 g/L, p<0.001) and higher American Society of Anaesthesiologists (ASA) scores, with more patients classified as ASA 4 and 5 (33.7% and 12.9% vs. 14.8% and 9.9%, p=0.024). The median hospital stay was longer in the hypoalbuminemia group (10 vs. 7 days, p=0.006). Wound dehiscence was more frequent (11.9% vs. 2.5%, p=0.018), and mortality was significantly higher (11.9% vs. 3.7%, p=0.046), highlighting the association between low preoperative albumin and worse surgical outcomes. Conclusions Preoperative serum albumin effectively predicts surgical outcomes after open abdominal surgery. It serves as a valuable, cost-effective risk predictor that should be further explored for integration into preoperative assessments.