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
References
  1. Huang W, Qin S, Sun Y, Yin S, Fan X, Huang Q, Chen T, Liang H. Establishment of multiple organ dysfunction syndrome early warning score in patients with severe trauma and its clinical significance: a multicenter study. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Jan;30(1):41-46. doi: 10.3760/cma.j.issn.2095-4352.2018.01.008 [Article in Chinese]
  2. Wang S, Li T, Li Y, Zhang J, Dai X. Predictive value of four different scoring systems for septic patients outcome: a retrospective analysis with 311 patients. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Feb;29(2):133-38. doi: 10.3760/cma.j.issn.2095-4352.2017.02.008 [Article in Chinese]
  3. Schmidt de Oliveira-Netto AC, Morello LG, Dalla-Costa LM, Petterle RR, Fontana RM, Conte D, Pereira LA, Raboni SM. Procalcitonin, C-Reactive Protein, Albumin, and Blood Cultures as Early Markers of Sepsis Diagnosis or Predictors of Outcome: A Prospective Analysis. Clin Pathol. 2019 Jun 18;12:2632010X19847673. doi: 10.1177/2632010X19847673. eCollection 2019 Jan-Dec.
  4. Gvozdik P, ononov VS, Dorofejev VD, Nartaylakov . Diagnosis and correction of liver dysfunction in abdominal sepsis. Annaly Khirurg Gepatologii. 2011;16(1):40-44. http://vidar.ru/Article.asp?fid=ASH_2011_1_40 (In Russ.)
  5. Feng JY, Chien JY, Kao KC, Tsai CL, Hung FM, Lin FM, Hu HC, Huang KL, Yu CJ, Yang KY. Predictors of early onset multiple organ dysfunction in major burn patients with ventilator support: experience from a mass casualty explosion. Sci Rep. 2018 Jul 19;8(1):10939. doi: 10.1038/s41598-018-29158-3
  6. Liao MH, Chen SJ, Tsao CM, Shih CC, Wu CC. Possible biomarkers of early mortality in peritonitis-induced sepsis rats. J Surg Res. 2013 Jul;183(1):362-70. doi: 10.1016/j.jss.2013.01.022
  7. Salekhov SA, Sarsembaev BK, Imanbaev AK. Korrektsiia detoksikatsionnoi funktsii pecheni pri abdominalnom sepsise. Retsept. 2008;61(5):135-139. https://elibrary.ru/item.asp?id=20134478& (In Russ.)
  8. Chanchiev ZM. Features of acute liver failure in emergency abdominal surgery. Elektronnyi resurs]. Sovremennye Problemy Nauki i Obrazovaniia. 2015;(6). [data obrashcheniia: 19.07.2019]. Available from: http://www.science-education.ru/ru/article/view?id=23384 (In Russ.)
  9. Sorokina OYu. Acute liver dysfunctions in intensive care unit patients and metabolic therapy methods. Meditsina Neotlozhnykh Sostoianii. 2015;8(71):25-45. https://www.elibrary.ru/item.asp?id=25910942 (In Russ.)
  10. Sun JK, Mu XW, Li WQ, Tong ZH, Li J, Zheng SY. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol. 2013 Feb 14;19(6):917-22. doi: 10.3748/wjg.v19.i6.917
  11. Shumilina OV, Dostieva ZA, Muradov AM, Khamidov JB. Influence of lungs on common and efficient concentration of an albumin at patients with peritonitis. Nauch-Prakt Zhurn TIPPM (Dushanbe). 2012;(4):51-54. http://www.vestnik-ipovszrt.tj/?p=1091 (In Russ.)
  12. Yu X, Wan X, Wan L, Huang Q. Analysis of high risk factors of intensive care unit-acquired weakness in patients with sepsis. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Apr;30(4):355-359. doi: 10.3760/cma.j.issn.2095-4352.2018.04.014 [Article in Chinese]
  13. Wang B, Chen G, Cao Y, Xue J, Li J, Wu Y. Correlation of lactate/albumin ratio level to organ failure and mortality in severe sepsis and septic shock. J Crit Care. 2015 Apr;30(2):271-75. doi: 10.1016/j.jcrc.2014.10.030
  14. Magnussen B, Oren Gradel K, Gorm Jensen T, Kolmos HJ, Pedersen C, Just Vinholt P, Touborg Lassen A. Association between Hypoalbuminaemia and Mortality in Patients with Community-Acquired Bacteraemia Is Primarily Related to Acute Disorders. PLoS One. 2016 Sep 9;11(9):e0160466. doi: 10.1371/journal.pone.0160466. eCollection 2016.
  15. Yin M, Si L, Qin W, Li C, Zhang J, Yang H, Han H, Zhang F, Ding S, Zhou M, Wu D, Chen X, Wang H. Predictive value of serum albumin level for the prognosis of severe sepsis without exogenous human albumin administration: a prospective cohort study. J Intensive Care Med. 2018 Dec;33(12):687-94. doi: 10.1177/0885066616685300
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
Contacts | ©Vitebsk State Medical University, 2007-2023