ArticleJournal of cardiothoracic surgery2026
Protein losing enteropathy and hypoalbuminemia after cardiac surgery.
Article in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
rationalePostoperative hypoalbuminemia is a common, persistent, and ominous abnormality following major surgery and has uncertain etiology. The purpose of this study was to investigate the incidence of protein-losing enteropathy as measured by alpha-1-antitrypsin clearance after major surgery.
methodsWe conducted a prospective cohort study of consecutive patients undergoing cardiac surgery at one hospital (n = 38, mean age = 65 years, male = 79%). Alpha-1-antitrypsin was measured in both blood and stool samples using standard techniques for diagnosing protein-losing enteropathy. Sensitivity, specificity, and predictive indices were calculated taking into account the measured serum albumin concentration.
findingsPostoperative hypoalbuminemia was a common finding and occurred in 82% of patients (95% confidence interval: 66 to 91). Paired analyses of blood and stool for alpha-1-antitrypsin clearance showed protein-losing enteropathy in 39% of patients (95% confidence interval: 26 to 55). Stool alpha-1-antitrypsin clearance for detecting postoperative hypoalbuminemia had a sensitivity of 48% (95% confidence interval: 30 to 67) and a specificity of 100% (95% confidence interval: 59 to 100). The positive predictive value was about 100% (95% confidence interval: 59 to 100).
conclusionsWe suggest protein-losing enteropathy may partially explain some cases of postoperative hypoalbuminemia after cardiac surgery.
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