ArticleBMJ open2017
Is postoperative decrease of serum albumin an early predictor of complications after major abdominal surgery? A prospective cohort study in a European centre.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02356484 (Predictive Value of Surgical Stress Markers for Postoperative Complications), which is not on this map. Cited by 51 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Predictive Value of Surgical Stress Markers for Postoperative Complications: a Prospective Study
Who cites it
51 citing papers in PubMed, 101 citations in OpenAlex.
- Favorable safety outcomes of a perioperative propranolol and etodolac regimen in cancer patients in four randomized controlled trials.Frontiers in pharmacology · 2026Trial
- The effect of pre-operative carbohydrate loading in femur fracture: a randomized controlled trial.BMC musculoskeletal disorders · 2022Trial
- Association Between Postoperative Day 7 Hypoalbuminemia and Mortality After Surgery: A Single-Center Retrospective Landmark Cohort Study.Journal of clinical medicine · 2026Article
- Early prediction of severe morbidity after liver resection using serum albumin and ALBI-score in a mixed patient cohort.BMC surgery · 2026Article
- Preoperative and early postoperative albumin thresholds, rather than ΔAlb, predict severe complications after colorectal cancer surgery: a multifactorial model and nomogram.Frontiers in oncology · 2026Article
- The Role of Lactate in Cancer Immunotherapy: Mechanisms and Applications.Current cancer drug targets · 2026Review
- Observational
- Postoperative serum albumin drop predicts complications in primary total knee arthroplasty: a retrospective cohort study using XGBoost algorithm.BMC musculoskeletal disorders · 2025Article
- Article
- Albumin: A Review of Market Trends, Purification Methods, and Biomedical Innovations.Current issues in molecular biology · 2025Review
- Risk factors for in-hospital mortality in surgical patients with abdominal sepsis in China: a nested case-control study.BMJ open · 2025Article
- The association of perioperative serum albumin concentrations with outcome after deceased donor liver transplantation.BMC anesthesiology · 2025Article
- Prognostic value of postoperative decrease of albumin (ΔAlb) in combination with GLIM-defined malnutrition for the prediction of postoperative outcomes in rectal cancer patients with normal preoperative albumin levels.Frontiers in nutrition · 2025Article
- Effect of human serum albumin on clinical outcomes in pediatric patients undergoing gastrointestinal surgery.Frontiers in pediatrics · 2025Article
- Postoperative hypoalbuminemia and outcomes of pediatric liver transplantation.BMC pediatrics · 2024Article
- The relationship between perioperative serum albumin and contrast-induced acute kidney injury in patients after percutaneous coronary intervention.BMC nephrology · 2024Article
- Association between early postoperative hypoalbuminaemia and outcome after orthotopic heart transplantation.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- Article
- Sarcopenia assessed by total psoas index - is it correlated with post-operative complications in all digestive cancers?Medicine and pharmacy reports · 2023Article
- Relative decline in serum albumin help to predict anastomotic leakage for female patients following sphincter-preserving rectal surgery.BMC surgery · 2023Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test postoperative serum albumin drop (ΔAlb) as a marker of surgical stress response and early predictor of clinical outcomes.
designProspective cohort study (NCT02356484). Albumin was prospectively measured in 138 patients undergoing major abdominal surgery. Blood samples were collected before surgery and on postoperative days 0, 1 2 and 3. ΔAlb was compared to the modified estimation of physiologic ability and surgical stress (mE-PASS) score and correlated to the performances of C reactive protein (CRP), procalcitonin (PCT) and lactate (LCT). Postoperative outcomes were postoperative complications according to Clavien classification and Comprehensive Complication Index (CCI), and length of hospital stay (LoS).
settingDepartment of abdominal surgery in a European tertiary centre.
participantsAdult patients undergoing elective major abdominal surgery, with anticipated duration ≥2 hours. Patients on immunosuppressive or antibiotic treatments before surgery were excluded.
resultsThe level of serum albumin rapidly dropped after surgery. ΔAlb correlated to the mE-PASS score (r=0.275, p=0.01) and to CRP increase (r=0.536, p<0.001). ΔAlb also correlated to overall complications (r=0.485, p<0.001), CCI (r=0.383, p<0.001) and LoS (r=0.468, p<0.001). A ΔAlb ≥10 g/L yielded a sensitivity of 77.1% and a specificity of 67.2% (AUC: 78.3%) to predict complications. Patients with ΔAlb ≥10 g/L on POD 1 showed a threefold increased risk of overall postoperative complications.
conclusionsEarly postoperative decrease of serum albumin correlated with the extent of surgery, its metabolic response and with adverse outcomes such as complications and length of stay. A decreased concentration of serum albumin ≥10 g/L on POD 1 was associated with a threefold increased risk of overall postoperative complications and may thus be used to identify patients at risk.
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