Pre-operative Serum Albumin and Surgical Outcomes in Emergency Abdominal Surgeries: A Prospective Observational Study at a Tertiary Care Centre in Pune, India

Abstract Introduction: Hypoalbuminaemia is a well-recognised predictor of poor surgical outcomes. In emergency abdominal surgeries, where pre-operative optimisation is limited, serum albumin can serve as a simple biomarker to anticipate complications and hospital stay. The study aimed to evaluate the association of pre-operative serum albumin levels with surgical outcomes, to assess the correlation between hypoalbuminaemia and post-operative complications and to determine its impact on duration of hospital stay and mortality. Methods: A prospective observational study was conducted in the Department of General Surgery of a tertiary care hospital over 18 months. Two hundred adult patients were in the study. Patients were followed for 30 days for complications, duration of stay and outcomes. Data were analysed using the Chi-square test, t -test, ANOVA, Pearson correlation, and receiver operating characteristic (ROC) curve analysis. P < 0.05 was considered statistically significant. Results: The mean age was 43.57 ± 17.54 years with male predominance (66%). Hypoalbuminaemia was noted in 78.5% of patients. Post-operative complications were significantly higher in hypoalbuminaemic patients, including surgical site infections (36.3%), pneumonia (66.9%) and acute kidney injury (AKI) (49.7%) ( P < 0.0001). Mortality was 22.3% in hypoalbuminaemic patients. ROC analysis showed serum albumin ≤2.55 g/dL predicted mortality (area under the curve [AUC] – 0.796) and ≤2.85 g/dL predicted pneumonia (AUC – 0.833) and AKI (AUC – 0.866). Conclusion: Pre-operative hypoalbuminaemia is a strong predictor of post-operative morbidity, mortality and prolonged hospital stay in emergency abdominal surgeries.