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Pre‐operative serum albumin level substantially predicts post‐operative morbidity and mortality among patients with colorectal cancer who undergo elective colectomy
Author(s) -
Chiang J.M.,
Chang C.J.,
Jiang S.F.,
Yeh C.Y.,
You J.F.,
Hsieh P.S.,
Huang H.Y.
Publication year - 2017
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12403
Subject(s) - medicine , albumin , serum albumin , colorectal cancer , logistic regression , gastroenterology , hypoalbuminemia , colectomy , multivariate analysis , mortality rate , subgroup analysis , cancer , surgery , confidence interval
The quantitative relationship between serum albumin level and surgical outcomes has not been clearly established. This study included 3732 patients with colon cancer who underwent a potentially curative colectomy. Post‐operative mortality and morbidity were analysed according to the patients' demographic data, pre‐operative comorbidities, and tumour‐related factors. Age, asthma, renal impairment, and albumin level were significantly associated with post‐operative morbidity and mortality in the multivariate analyses. Logistic regression analysis revealed linear relationships of post‐operative morbidity and mortality with albumin level. The morbidity and mortality rates decreased by 7.3% and 15.6%, respectively, for each 0.1 g/dL increase in albumin level. This finding remained significant in the hypoalbuminaemia subgroup but not in the normoalbuminaemia subgroup. That is, the morbidity and mortality rates significantly decreased by 8.7% and 17.7%, respectively (both P < 0.001), in the former group and decreased by 2.7% ( P = 0.112) and 11.6% ( P = 0.092), respectively, in the latter group. This study demonstrated that serum albumin level linearly predicted the post‐operative morbidity and mortality among the colorectal cancer patients. Pre‐operative serum albumin level may therefore be used as a continuous rather than a categorical marker of disease severity, especially among patients with hypoalbuminaemia.