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Cited by 191Enhanced Recovery After SurgeryHyperglycemia and glycemic control in critically ill and hospitalized patientsSepsis Diagnosis and Treatment

Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study

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Hübner, Martin, Mantziari, Styliani, Demartines, Nicolas, Pralong, François, Coti-Bertrand, Pauline, Schäfer, Markus·2016·Gastroenterology Research and Practice
DOI 10.1155/2016/8743187PMC PMC4736779
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Abstract

Background. Surgical stress during major surgery may be related to adverse clinical outcomes and early quantification of stress response would be useful to allow prompt interventions. The aim of this study was to evaluate the acute phase protein albumin in the context of the postoperative stress response.Methods. This prospective pilot study included 70 patients undergoing frequent abdominal procedures of different magnitude. Albumin (Alb) and C-reactive protein (CRP) levels were measured once daily starting the day before surgery until postoperative day (POD) 5. Maximal Alb decrease (Alb Δ min) was correlated with clinical parameters of surgical stress, postoperative complications, and length of stay.Results. Albumin values dropped immediately after surgery by about 10 g/L (42.2±4.5 g/L preoperatively versus 33.8±5.3 g/L at day 1,P<0.001). Alb Δ min was correlated with operation length (Pearsonρ=0.470,P<0.001), estimated blood loss (ρ=0.605,P<0.001), and maximal CRP values (ρ=0.391,P=0.002). Alb Δ min levels were significantly higher in patients having complications (10.0±5.4 versus 6.1±5.2,P=0.005) and a longer hospital stay (ρ=0.285,P<0.020).Conclusion. Early postoperative albumin drop appeared to reflect the magnitude of surgical trauma and was correlated with adverse clinical outcomes. Its promising role as early marker for stress response deserves further prospective evaluation.

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  • Thereafter, CRP drops quickly after 3-4 days to low but still modestly increased levels if the proinflammatory phase is successful.

    “Thereafter, CRP drops quickly after 3–4 days to low, but still modestly increased, levels if the proinflammatory phase is successful.147”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [147]

    The Results (§3.1) say CRP peaked on postoperative day 2 and then decreased slowly, contrary to the claimed quick drop after 3–4 days. The cited passages do not establish that it reached low levels or link its decline to a successful proinflammatory phase. (LLM, conf=0.87)

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  • In the anti-inflammatory phase, CRP is neither a precise indicator of the severity of the metabolic response nor a very precise indicator of improvement or deterioration of the clinical state.

    “Thereafter, in the anti‐inflammatory phase, CRP is neither a precise indicator of the severity of the metabolic response, nor a very precise indicator of whether there is improvement or deterioration of the clinical state.147”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [147]

    The Introduction and Discussion say CRP responds slowly after surgery, limiting its usefulness for early assessment, and Results §3.2 show that it underestimated surgical stress after liver resection. The paper does not assess CRP specifically in an anti-inflammatory phase or establish that it is imprecise for detecting improvement versus deterioration in clinical state. (LLM, conf=0.85)

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Authors
Hübner, M., Mantziari, S., Demartines, N., Pralong, F., Coti-Bertrand, P., & Schäfer, M.
Affiliations
  • Centre Hospitalier Universitaire Vaudois (CH)
  • Department of Visceral Surgery and Transplantation and Department of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
Corresponding author
Demartines, Nicolas
ORCID
Venue
Gastroenterology Research and Practice
Publisher
Hindawi Limited
Published
2016
Volume
2016
Pages
1-8
ISSN
  • 1687-6121 (ISSN-L)
  • 1687-630X
DOI
10.1155/2016/8743187
PMC
PMC4736779
OpenAlex
W2223161052
Cited by
191
References
45
Citations by year
2026: 19 · 2025: 15 · 2024: 9 · 2023: 15 · 2022: 28 · 2021: 22 · 2020: 24 · 2019: 21 · 2018: 17 · 2017: 18 · 2016: 3
FWCI
21.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Gastroenterology Research and Practice (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • IRIS (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • SERVAL (Université de Lausanne) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
surgical stress response, acute phase proteins, C-reactive protein, postoperative complications, length of hospital stay, abdominal surgery, surgical trauma, blood loss, early biomarkers

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