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Postoperative hypoalbuminemia is associated with outcome in patients undergoing off-pump coronary artery bypass graft surgery.

Abstract：

OBJECTIVE:The authors aimed to investigate whether immediate postoperative hypoalbuminemia could be associated with outcomes after off-pump coronary artery bypass graft (OPCAB) surgery. DESIGN:A retrospective analysis of the medical data. SETTING:Cardiac operating room and adult cardiovascular intensive care unit at a single institution. PARTICIPANTS:Six hundred ninety adult patients underwent elective OPCAB surgery over a 30-month period. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:To evaluate the clinical relevance of immediate postoperative hypoalbuminemia, the lowest serum albumin level measured over the first 12 hours postoperatively was recorded. A cutoff point was calculated by the area under the curve in the receiver operating characteristic plot for 30-day adverse events including death. Patients were classified according to the cutoff value, and outcomes were compared between groups using propensity score-matching analysis. The impact of immediate postoperative hypoalbuminemia on OPCAB outcome was investigated using multivariate analysis. The cutoff value for immediate postoperative albumin concentration for predicting 30-day adverse events was 2.3 g/dL. Immediate postoperative hypoalbuminemia (<2.3 g/dL) was associated independently with postoperative respiratory failure (odds ratio [OR] = 8.85, p = 0.04), wound infection (OR = 4.44, p = 0.04), the need for an intra-aortic balloon pump after the operation (OR = 13.7, p = 0.02), renal failure (OR = 7.98, p = 0.01), reoperation for bleeding (OR = 4.33, p = 0.05), and the need for inotropes in the intensive care unit (OR = 1.79, p = 0.02). CONCLUSIONS:Immediate postoperative hypoalbuminemia was associated with poorer outcomes in OPCAB patients. Monitoring of albumin levels after OPCAB could identify patients at risk for short-term adverse events.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Lee EH,Chin JH,Choi DK,Hwang BY,Choo SJ,Song JG,Kim TY,Choi IC

doi

10.1053/j.jvca.2010.09.008

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

462-8

issue

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(10)00404-0

journal_volume

pub_type

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Postoperative hypoalbuminemia is associated with outcome in patients undergoing off-pump coronary artery bypass graft surgery.