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Leakage of albumin levels during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy predicts the major complications
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2024-05-21T18:40:37.957+0200 Kim, H (via Mendeley Data) 10.17632/bwvtk53mvj.1
Background: Little is known about the clinical consequences of perioperative extravasation of albumin that inevitably accompanies major abdominal surgery. Methods: We retrospectively reviewed the data of patients who underwent cytoreductive surgery (CRS) and hyperthermic in-traoperative peritoneal chemotherapy (HIPEC). Parameters of albumin kinetics, including a de-crease in serum albumin concentration (Alb) and the amount of extravasated albumin (Albshift), were assessed from surgery until postoperative day (POD) 3. Major postoperative complications were defined as Clavien–Dindo Class III-IV. Logistic regression analysis identified independent predictors of major postoperative complications. The predictive ability of albumin kinetics was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Serum albumin levels decreased during surgery and subsequently increased. Of the 121 analyzed patients, 25 (21%) developed major postoperative complications. The Alb and Albshift during surgery and on POD3 were greater in patients who developed major complications than in those who did not (12 ± 12 vs. 6 ± 14, P = 0.032 and 127.5 (71.9) vs. 48.5 (44.9), P < 0.001, respectively). Perioperative Alb and Albshift were associated with major postoperative complications. The area under the ROC curve of Albshift during 3 days after surgery and Albshift up to POD3 were 0.843 (95% confidence interval [CI]: 0.761-0.924) and 0.910 (95% CI: 0.856-0.964), respectively. Albshift during 3 days after surgery and Albshift up to POD3 were predictive of complications (P < 0.05). Conclusion: Perioperative albumin loss is closely associated with major postoperative complications in patients undergoing CRS and HIPEC. Albshift was an effective predictive factor for serious complications.
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