The Association Of Peri-operative M-POSSUM Scores And Serum Albumin Level In Patients Undergoing Moderate-larger Operations In Dept. Of General Surgery

Objective To analyze the association of peri-operative M-POSSUM scores and serum albumin level in patients undergoing moderate-larger operations in Dept.of General Surgery,and investigate the risk factors causing post-operative hypo-albuminaemia and explore factors determining post-operative serum albumin level.Methods Retrospective study was performed on 133 patients who underwent moderate-larger operations in Dept.of General Surgery from January 2008 to December 2008,that pre-operative and post-operative M-POSSUM scores,hematocrit,plasma protein,serum albumin,pre-albumin and C-reactive protein were examined respectively, and peri-operative blood transfusion was also recorded and analyzed.The comparison was carried out and multiple single factors that were possible related to post-operative hypo-albuminaemia were analyzed.Multivariate regression analysis was also applied to ascertain factors determining post-operative serum albumin level.Results The post-operative hypo-albuminaemia rate was 96.9%,compared with pre-operative 39.8%proved extremely significant(χ~2=73.013,P＜0.001).Single factor correlation analysis showed that post-operative hypo-albuminaemia was close to pre-operative serum total protein(r=0.1496,p=0.048),serum albumin level(r=0.4252, p=0.000),serum pre-albumin level(r=0.4530,p=0.000),post-operative serum pre-albumin level(r=0.5160,p=0.000),serum C-reactive protein level(r=-0.3470, p=0.000) and post-operative M-POSSUM scores(r=-0.2342,p=0.006).Multivariate regression analysis revealed that a positive correlation was found between post-operative albuminaemia and pre-operative albuminaemia(b=0.4930,p=0.0000)as well as BMI(b=2.4133,p=0.0001) and a negative correlation was found with post-operative M-POSSUM scores(b=-0.0115,p=0.0195),pre-operative plasma protein(b=-0.2552, p=0.0117) and post-operative C-reactive protein level(b=-1.9116,p=0.0013).There was no difference between pre-operative and post-operative serum albumin of male and female patients(t=-0.699,p=0.489;t=1.546,p=0.125).Whereas pre-operative M-POSSUM scores,serum C-reactive protein level and post-operative M-POSSUM scores,serum C-reactive protein level were found difference(r=0.3600,p=0.000; r=0.2950,p=0.001).It is suggested that human albumin should be used to the high risk patients with M-POSSUM scores》10,serum albumin level《25g/L.With regard to the patients subjected to special diseases-intestinal fistula,human albumin should be administered to correct post-operative hypo-albuminaemia according to actual status,not but only serum albumin level＜25g/L.Conclusion Post-operative albuminaemia in patients with moderate-larger operations is linear positively correlated with pre-operative albuminaemia and BMI,and linear negatively with the pre-operative plasma total protein,post-operative M-POSSUM scores and C-reactive protein level.It is suggested that human albumin should be used to the high risk patients with M-POSSUM scores》10,serum albumin level《25g/L.With regard to the patients subjected to special diseases-intestinal fistula,human albumin should be administered to correct post-operative hypo-albuminaemia according to actual status,not but only serum albumin level＜25g/L.