Preoperative albumin levels predict prolonged postoperative ileus in gastrointestinal surgery

作     者：Wen-Quan Liang Ke-Cheng Zhang Hua Li Jian-Xin Cui Hong-Qing Xi Ji-Yang Li Ai-Zhen Cai Yu-Hua Liu Wang Zhang Lan Zhang Bo Wei Lin Chen 

作者机构：Department of General Surgery&Institute of General SurgeryChinese People’s Liberation Army General HospitalBeijing 100853China Department of Surgical OncologyXing Tai People's HospitalXingtai 054001Hebei Province China Institute of Army Hospital ManagementChinese People’s Liberation Army General HospitalBeijing 100853China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第11期

页      面：1185-1196页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：the National Nature Science Foundation of China,No.81672319 and No.81972790 Beijing Nova Program,No.Z181100006218011 

主　　题：Albumin Prolonged postoperative ileus Gastrointestinal surgery Nomogram Complications 

摘      要：BACKGROUND Prolonged postoperative ileus(PPOI) is a prolonged state of pathologicalgastrointestinal(GI) tract dysmotility. There are relatively few studies examining the influence of preoperative nutritional status on the development of PPOI in patients who underwent GI surgery. The association between preoperative albumin and PPOI has not been fully studied. We hypothesized that preoperative albumin may be an independent indicator of *** To analyze the role of preoperative albumin in predicting PPOI and to establish a nomogram for clinical risk *** Patients were drawn from a prospective hospital registry database of GI surgery.A total of 311 patients diagnosed with gastric or colorectal cancer between June 2016 and March 2017 were included. Potential predictors of PPOI were analyzed by univariate and multivariable logistic regression analyses, and a nomogram for quantifying the presence of PPOI was developed and internally *** The overall PPOI rate was 21.54%. Advanced tumor stage and postoperative opioid analgesic administration were associated with PPOI. Preoperative albumin was an independent predictor of PPOI, and an optimal cutoff value of 39.15 was statistically calculated. After adjusting multiple variables, per unit or per SD increase in albumin resulted in a significant decrease in the incidence of PPOI of 8%(OR = 0.92, 95%CI: 0.85-1.00, P = 0.046) or 27%(OR = 0.73, 95%CI:0.54-0.99, P = 0.046), respectively. Patients with a high level of preoperative albumin(≥ 39.15) tended to experience PPOI compared to those with low levels( 39.15)(OR = 0.43, 95%CI: 0.24-0.78, P = 0.006). A nomogram for predicting PPOI was developed [area under the curve(AUC) = 0.741] and internally validated by bootstrap resampling(AUC = 0.725, 95%CI: 0.663-0.799).CONCLUSION Preoperative albumin is an independent predictive factor of PPOI in patients who underwent GI surgery. The nomogram provided a model to screen for early indications in the clinic