Impact of preoperative prealbumin on outcomes after cardiac surgery
Abstract
Background: Preoperative malnutrition is increasingly prevalent in patients undergoing cardiac surgery. Although prealbumin is a widely used indicator of nutrition status, its use in the preoperative assessment of patients undergoing cardiac surgery is not well defined. The purpose of this study is to determine the impact of preoperative prealbumin levels on outcomes after cardiac surgery. Materials and Methods: Data were prospectively gathered from February 2013 to July 2013 on 69 patients undergoing cardiac surgery. Prealbumin levels were obtained within 24 hours of surgery. Patients were divided into 2 groups based on a prealbumin cutoff value of 20 mg/dL. Results: Of the 69 patients, 32 (46.4%) had a preoperative prealbumin ≤20 mg/dL. There was no correlation between prealbumin levels and body mass index (r = −0.13, P = .28). Likewise, there was no correlation between preoperative albumin and prealbumin levels (r = 0.09, P = .44). Nine of 32 (28.1%) patients with low preoperative prealbumin levels had postoperative infections compared with 2 of 37 (5.4%) patients with high prealbumin levels (P = .010). Patients with low prealbumin levels also had increased risk of postoperative intubation for >12 hours (P = .010). Conclusions: Patients undergoing cardiac surgery with preoperative prealbumin levels of ≤20 mg/dL have an increased risk for postoperative infections and the need for longer mechanical ventilation. If feasible, nutrition optimization of such patients may be considered prior to cardiac surgery.
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Albumin <3.0 g/dL and prealbumin ≤20 mg/dL have been used as acute-phase markers to trigger nutritional supplementation within 1 week of surgery, although they are not good markers of nutritional status.
“Although not good markers of nutritional status, albumin <3.0 g/dL and prealbumin ≤20 mg/dL have been used as acute-phase markers to trigger nutritional supplementation within 1 week of surgery.186,189–191”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [189]
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Qiu, L., Lin, Z., Yang, L.-K., Li, M., & Cheng, L. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1707892 · Cited by 4 · see citing works
Culp, C., & Manning, M. W. (2025) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2025.02.040 · Cited by 3 · see citing works
Божкова, С. А., Ливенцов, В. Н., Муртузалиевич, Т. Р., Romanò, C. L., Kochish, A. Y., Labutin, D. V., & Алексеевич, А. В. (2022) · Traumatology and Orthopedics of Russia · doi:10.17816/2311-2905-1717 · Cited by 3 · see citing works
Meleis, M. H., Rizk, M. M., Hassan, N., & Mohamed, S. A. (2018) · Indian Journal of Gynecologic Oncology · doi:10.1007/s40944-018-0214-9 · Cited by 3 · see citing works
Calabuig, J. A. M., Pajares, M. A., Camacho, C. G., Castaño, M., Gómez, M., Suárez, J. G., Soto, M. J., Menéndez, J. L., Gutiérrez, E. M., Blanco-Morillo, J., et al. (2020) · Revista Española de Perfusión · doi:10.36579/rep.2020.supl · Cited by 2 · see citing works
Calabuig, J. A. M., Pajares, M. A., Camacho, C. G., Castaño, M., Gómez, M., Suárez, J. G., Soto-Viudez, M. J., Menéndez, J. L., Gutiérrez, E. M., Blanco-Morillo, J., et al. (2020) · Cirugía Cardiovascular · doi:10.1016/j.circv.2020.11.004 · Cited by 2 · see citing works
Blood transthyretin for predicting immunoglobulin A vasculitis nephritis outcome in children
Ma, X., Sun, Y., Wang, D., Lin, Y., & Chang, H. (2022) · International Immunopharmacology · doi:10.1016/j.intimp.2022.108765 · Cited by 1 · see citing works
Causes of Mediastinitis and Its Surgical Treatment
Yu, Y., Xia, J., & Jiang, Q. (2024) · The Heart Surgery Forum · doi:10.59958/hsf.7617 · Cited by 1 · see citing works
Merás, P., Cobarro, L., Argos, C. M., Ruiz-Cantador, J., Jimenez, S., Balbacid, E., Abelleira, C., & Moreno, R. (2025) · Cardiology in the Young · doi:10.1017/s1047951125001337 · Cited by 1 · see citing works
Jacques, A., Niedzielak, T., Eaddy, S. G., Santos, R., Tannenbaum, S. L., Rush, J., Keener, E., Neway, W., Roth, B., Pérez, E., et al. (2025) · OTA International · doi:10.1097/oi9.0000000000000402 · Cited by 1 · see citing works
Association between perioperative prealbumin level and outcomes in coronary bypass surgery patients
Rabenstein, A. P., Matta, R., Williams, B. A., Brocious, J., Campana, R., Meknat, A., Forrest, S., Bailey, S. H., & Halbreiner, M. S. (2025) · Coronary Artery Disease · doi:10.1097/mca.0000000000001572 · Cited by 1 · see citing works
Lu, R., He, L., Huang, Z., Li, W., Liu, J., Lao, Y., Liu, Q., & Ding, X. (2025) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-025-03196-0 · Cited by 1 · see citing works
Prehabilitation in cardiac surgery
Majeed, H., Patel, S. K., Hassan, S. M. A., Alli, A., Yanagawa, B., Yau, T. M., Mazer, C. D., & Verma, S. (2026) · JTCVS Open · doi:10.1016/j.xjon.2026.101595 · Cited by 1 · see citing works
Oliveira, L. A. S., Cabette, N. N., Valladão, V. D. C. S., Mendes, L. H., & Zanella, F. (2026) · Cureus · doi:10.7759/cureus.111477 · Cited by 1 · see citing works
Noteworthy Articles in 2015 for Cardiothoracic Critical Care
Evans, A. S., Mazzeffi, M. A., Ivascu, N. S., Dickerson, S. C., & Gutsche, J. T. (2016) · Seminars in Cardiothoracic and Vascular Anesthesia · doi:10.1177/1089253215626004 · Cited by 1 · see citing works
Kintz, T., & Riley-Doucet, C. K. (2017) · Journal of Doctoral Nursing Practice · doi:10.1891/2380-9418.10.2.121 · Cited by 1 · see citing works
Nutrition of the Critically Ill Adult with Congenital Heart Disease and Nutritional Rehabilitation
Dolgner, S. J., & Deen, J. F. (2018) · Congenital heart disease in adolescents and adults · doi:10.1007/978-3-319-94171-4_24 · Cited by 1 · see citing works
Pajares, M. A., Margarit, J. A., Camacho, C. G., Suárez, J. G., Mateo, E., Castaño, M., Forte, C. L., Menéndez, J. L., Gómez, M., Soto, M. J., et al. (2021) · Revista Española de Anestesiología y Reanimación (English Edition) · doi:10.1016/j.redare.2020.11.002 · Cited by 1 · see citing works
Xia, L., Wang, T., Chen, X., He, Y., Zhou, L., Lin, Q., Wang, Y., Feng, Y., Shi, H., & Qian, D. (2024) · Ear Nose & Throat Journal · doi:10.1177/01455613241254241 · Cited by 1 · see citing works
Trufa, D. I., Arhire, L. I., Grigorescu, C., Mihalache, L., Niță, O., Graur, M., & Mihai, B. M. (2015) · Revista română de medicină de laborator · doi:10.1515/rrlm-2015-0011
Chuang, C.-C., Chen, J., & Lee, C.-C. (2016) · Acta anaesthesiologica Taiwanica · doi:10.1016/j.aat.2016.11.001
Preoperative Nutritional Management
McAnally, H. B. (2019) · doi:10.1093/med/9780190920142.003.0008
Mozumder, M. N.-E.-E., Rahman, M. M., Hoque, M. R., Imtiaz, M. N., Morshed, A. J. M. T., Tareq, M. Z., & Morshed, M. N. (2020) · medRxiv · doi:10.1101/2020.10.13.20206409
Wang, Z., Zhang, M., Zhang, Y., He, Y., Qu, F., Bai, C., Zhang, L., Guo, Y., & Chang, H. (2021) · Research Square · doi:10.21203/rs.3.rs-567632/v1
KALP CERRAHİSİ SONRASI HIZLANDIRILMIŞ İYİLEŞME PROTOKOLÜ
Mert, S., & Sayılan, A. A. (2021) · Ege Üniversitesi Hemşirelik Fakültesi Dergisi · doi:10.53490/egehemsire.651868
Sabile, J. M. G., Tran, A. A., & Tun, N. (2022) · BMJ Case Reports · doi:10.1136/bcr-2022-249683
(2020) · Revista Española de Perfusión · doi:10.36579/rep.2020.suplemento
Rente, A. F. G., Resende, B. S., Motta, F. A., Krettli, H. G., da Silva, M. A. F., Bolina, R. P., López, S. A., Christino, T. G. T., & Vieira, W. P. F. D. C. (2024) · EPITAYA eBooks · doi:10.47879/ed.ep.2024479p277
Salahuddin, A. P., Chowdhury, M. A. T., Magdum, M., Chowdhury, D. I. R., Pal, N., Morshed, M. N., Zafar-Al-Nimari, M., Nasrin, L., & Ahmed, F. (2024) · World Journal of Cardiovascular Surgery · doi:10.4236/wjcs.2024.148014
Zeng, Z., Luo, R., & Lan, X. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s532170
Kitakaze, M., Paku, M., Sugimoto, S., Nagai, K., Suzuki, R., & Fukuchi, N. (2025) · Nihon Daicho Komonbyo Gakkai Zasshi · doi:10.3862/jcoloproctology.79.1
Pilis, K., Rojczyk, E., Valach, P., Pilis, A., Dolibog, P., Katarzyna, G., & Wiesław, P. (2025) · Scientific Reports · doi:10.1038/s41598-025-32851-9
Prehabilitation in Cardiovascular Surgery: Concepts, Evidence, and Future Direction
Sidik, A. I., Al-Ariki, M. K., Saghir, H., Rahimi, N. A., Sleiman, M. K., Tur, M., Djumanov, A. K., Ogurchikova, A. V., Karpenko, I. G., Dontsov, V. V., et al. (2026) · Cureus · doi:10.7759/cureus.106795
„Präha Herz Basel“ – Prähabilitation bei elektiven herzchirurgischen Eingriffen
Perrot, G., & Suter, P. (2026) · MSK – Muskuloskelettale Physiotherapie · doi:10.1055/a-2878-1560
Prognostic value of listing-phase prealbumin on outcomes following orthotopic heart transplantation
Costa, A. W., Falama, R., Meyer, M., Zhang, S., Bhamidipati, C. M., Colaco, N., & Masha, L. (2026) · Transplantation Reports · doi:10.1016/j.tpr.2026.100214
- Authors
- Yu, P., Cassiere, H. A., Dellis, S. L., Manetta, F., Kohn, N., & Hartman, A. R.
- Affiliations
- North Shore University Hospital (US)
- Feinstein Institute for Medical Research (US)
- Corresponding author
- Yu, Pey‐Jen
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2014-06-04
- Volume
- 39
- Issue
- 7
- Pages
- 870-874
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- OpenAlex
- W2085377408
- Cited by
- 98
- References
- 27
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 7 · 2020: 13 · 2019: 9 · 2018: 8 · 2017: 5 · 2016: 11 · 2015: 5 · 2014: 2
- FWCI
- 7.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- prealbumin, cardiac surgery, preoperative malnutrition, nutritional assessment, postoperative infection, prolonged mechanical ventilation, preoperative albumin, diet optimization
- MeSH terms
- Aged, Aged, 80 and over, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Nutritional Status, Postoperative Complications, Prealbumin, Preoperative Care, Prospective Studies, Respiration, Artificial, Risk Factors, Nutrition Assessment, Body Mass Index, Malnutrition
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