Novosti
Khirurgii

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Year 2020 Vol. 28 No 2

ANESTHESIOLOGY-REANIMATOLOGY

S.A. TACHYLA

PROGNOSTIC VALUE OF TOTAL PROTEIN AND ALBUMIN LEVELS IN ABDOMINAL SURGERY PATIENTS

Mogilev Regional Hospital, Mogilev,
The Republic of Belarus

Objective. To study the dynamics of total protein and albumin levels in abdominal surgery patients, to determine their prognostic significance, sensitivity and specificity for the development of multiple organ dysfunction syndrome and mortality.
Methods. The prospective cohort study included patients with (n=459) previous surgical interventions in the abdominal surgery for the period from 2014 up to 2018. The 1st group consisted of patients without multiple organ dysfunction syndrome (n=280), the 2nd group – patients with multiple organ dysfunction syndrome (n=179). Of these patients, 23 died in the group 2 (12.8%). The levels of total protein and albumin were assessed daily. Logistic regression analysis was performed, receiver operating characteristic curves (ROC curves) were plotted, and the area under the curve (AUC) was also determined.
Results. Patients after the abdominal surgical interventions showed a statistically significant decrease in total protein and albumin. It is established that these markers in the early stages have a prognostic value in relation to multiple organ dysfunction syndrome. Total protein on the 1st and 2nd day after surgery AUC was 0.633 and 0.641, respectively (p<0.05). Albumin on the 1st, 2nd and 3rd day after surgery AUC was 0.673; 0.743 and 0.664, respectively (p<0.05). Albumin level is also a predictor of mortality: AUC – 0.639; 95% confidence interval – 0.584-0.695 (p<0.05). Total protein does not have a prognostic value in relation to mortality.
Conclusions. The studied parameters of total protein and albumin are prognostic markers of average diagnostic efficacy; their evaluation should be carried out in combination with other clinical and laboratory parameters. The level of albumin as a predictor has advantages, since, with a diagnostic value similar to that of a total protein, with respect to the prediction of multiple organ dysfunction syndrome, it is a prognostic marker of mortality.

Keywords: abdominal surgery, multiple organ dysfunction syndrome, mortality, prognosis, total protein, albumin
p. 180-187 of the original issue
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Address for correspondence:
212026, Republic of Belarus,
Mogilev, ul. Belyinitskii-Biruli, 12,
Mogilev Regional Hospital,
the intensive care unit,
tel./fax: +375(222) 50-08-81,
+375(222) 50-03-73,
e-mail: tsa80@inbox.ru,
Tachyla Siarhei A.
Information about the authors:
Tachyla Siarhei A., PhD, Physician of the ICU, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0003-1659-5902
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