Correlation Between Postoperative Complications and Serum Albumin Levels in Abdominal Surgery: A Prospective Observational Study

Background Hypoalbuminemia is a widely recognized marker of malnutrition and systemic inflammation. Its association with postoperative complications is increasingly emphasized in surgical risk stratification, particularly in abdominal procedures. However, limited prospective data from Indian populations exist to validate its predictive utility in routine clinical practice. Objective This study aimed yo assess the correlation between preoperative serum albumin levels and the incidence of postoperative complications in patients undergoing abdominal surgery. Methods This prospective observational study was conducted over a nine-month period at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna. A total of 69 patients undergoing elective or emergency abdominal surgery were enrolled. Preoperative serum albumin levels were measured within 24 hours prior to surgery, and patients were categorized into hypoalbuminemic (<3.5 g/dL) and normoalbuminemic (≥3.5 g/dL) groups. Postoperative complications, duration of hospital stay, and relevant demographic and clinical variables were recorded. Statistical analyses included Chi-square tests, Mann-Whitney U tests, and multivariate logistic regression. Results Among 69 patients, 45 (65.2%) were hypoalbuminemic. Postoperative complications were significantly more frequent in the hypoalbuminemic group, with 26 patients (57.8%) experiencing complications compared to only three of 24 patients (12.5%) in the normoalbuminemic group (p < 0.001). The mean hospital stay was also significantly longer in hypoalbuminemic patients (10.1 ± 2.9 days vs. 6.9 ± 2.0 days; p < 0.0001; Cohen's d = 1.32). Multivariate logistic regression identified hypoalbuminemia (OR = 12.68; 95% CI: 3.01-53.53; p = 0.001) and surgery duration (p = 0.045) as independent predictors of postoperative complications, while age and comorbidity status were not statistically significant. Conclusion Preoperative hypoalbuminemia is a strong and independent predictor of postoperative complications and prolonged hospitalization in patients undergoing abdominal surgery. Serum albumin should be routinely evaluated as part of preoperative assessment to guide perioperative planning and optimize outcomes.