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Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study
Open accessAbstract
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.147”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [147]
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“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]
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“Serum albumin is a negative acute phase maintenance protein that is rapidly downregulated by inflammatory signals.([5,29]) Postoperative decreases of serum albumin can be used as a marker of the surgical stress response and early predictor in the clinical outcome after major surgery.”
Background
Metadata
- 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
- Venue
- Gastroenterology Research and Practice
- Publisher
- Hindawi Limited
- Published
- 2016
- Volume
- 2016
- Pages
- 1-8
- ISSN
- 1687-6121 (ISSN-L)
- 1687-630X
- 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
- gold
- doi.org
- 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 › Critical Care and Intensive Care Medicine › 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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