Appropriateness of perioperative albumin administration in gastrointestinal tumor surgery patients without hypoalbuminemia: a propensity score-matched study.

introductionHuman albumin is frequently administered during perioperative care because of its physiological role in maintaining plasma oncotic pressure and modulating the inflammatory response. However, increasing evidence suggests that albumin is often prescribed outside guideline-supported indications, particularly in surgical patients with preserved serum albumin levels. However, the clinical benefits of perioperative albumin administration in this population remain uncertain.

aimTo evaluate the association between perioperative albumin administration and short-term postoperative outcomes in patients undergoing gastrointestinal tumor surgery with preserved preoperative serum albumin concentrations.

methodThis retrospective cohort study included adult patients who underwent gastrointestinal tumor resection at a tertiary teaching hospital. Patients with preoperative serum albumin concentrations ≥ 31 g/L were eligible. Propensity score matching (1:1) was used to balance the baseline characteristics between patients who received perioperative albumin and those who did not. The primary outcome was the incision drainage volume on postoperative day 2. Secondary outcomes included cumulative incision drainage volume on postoperative days 1-3, recovery-period serum albumin concentration, and postoperative hospital length of stay. Multivariable linear regression analyses were performed to evaluate the association between albumin administration and the outcomes.

resultsAfter propensity score matching, 248 patients (124 per group) were included in the final analysis of the study. Perioperative albumin administration was not associated with reduced incision-drainage volume on postoperative day 2 or during postoperative days 1-3 (p > 0.05). Albumin administration was independently associated with higher recovery-period serum albumin concentrations (t = 3.996, p < 0.001). However, patients receiving albumin had significantly longer postoperative hospital stays than those who did not (p = 0.002).

conclusionAmong patients undergoing gastrointestinal tumor surgery with preserved preoperative serum albumin levels, perioperative albumin administration was not associated with improvements in early postoperative drainage outcomes and was associated with longer hospitalization, despite increasing serum albumin levels. These findings suggest that routine perioperative albumin administration in patients without hypoalbuminemia may provide limited clinical benefits and should be carefully evaluated in clinical practice.