Association between postoperative hypoalbuminemia and complications in ovarian carcinoma

Abstract

Aim: Several factors have been described as risk factors for increased post-operative complications, such as age, performance status, surgical aggres-siveness, nutritional status, and serum albumin levels. The aim of the present study is to evaluate the predictive role of postoperative serum albumin levels on postoperative complications. Material and Method: Data of patients with the diagnosis of borderline ovarian tumors or invasive ovarian cancer and who had undergone debulking surgery were retrieved retrospectively. We de-fined the cut-off value of 3.5 g/dl for mild hypoalbuminemia and 2.5 g/dl for severe hypoalbuminemia. Results: A total of 200 patients were identified, all of whom had undergone debulking surgery at our hospital in the time period from January 2008 to December 2015. Patients with severe postoperative hypoalbuminemia had higher incidences of severe postoperative compli-cations (CDC grade ≥2) (p<0.05, OR 2.6, 95% CI: 0.7-9.1). Mean dissected lymph node counts for patients with severe hypoalbuminemia, mild hypoal-buminemia, and normal albumin levels were 57.2, 49.4, and 45.5, respectively (P<0.05). Patients with severe hypoalbuminemia had longer hospital stays (mean 10.26 days) and ICU stays (mean 1.5 days) compared to patients with mild hypoalbuminemia (9.3 and 1.3 days, respectively) and those with normal albumin levels (8.2 and 1.2 days, respectively) (p<0.05). Sixty percent of the patients with severe hypoalbuminemia, 42.4% of the patients with mild hy-poalbuminemia, and 20% of the patients with normal albumin levels needed at least one unit of packed RBC transfusion in the per-operative period. Dis-cussion: Patients with postoperative hypoalbuminemia have an increased risk of serious postoperative complications and they should be more closely fol-lowed during the early postoperative course.