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Association Between Postoperative Decrease of Albumin and Outcomes in Patients Undergoing Craniotomy for Brain

Yangchun Xiao1, Yaqing Zhao2, Xin Cheng2

  • 1Center for Evidence-Based Medical, Clinical Medical College and Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.

World Neurosurgery
|August 2, 2024
PubMed
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Delta albumin (ΔAlb) increase after craniotomy for brain tumors is linked to higher 30-day mortality. Even mild ΔAlb increases risk, regardless of nadir albumin levels, indicating its predictive value for patient outcomes.

Keywords:
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Area of Science:

  • Neurosurgery
  • Oncology
  • Clinical Biochemistry

Background:

  • Serum albumin is a key indicator of nutritional status.
  • Low postoperative albumin levels and significant drops (Delta albumin, ΔAlb) correlate with adverse outcomes.
  • ΔAlb may predict complications and mortality even when postoperative albumin exceeds 30 g/L.

Purpose of the Study:

  • To investigate the association between ΔAlb and patient outcomes following craniotomy for brain tumors.
  • To determine if ΔAlb predicts 30-day mortality in this patient cohort.

Main Methods:

  • Retrospective analysis of 9660 patients undergoing craniotomy for brain tumors.
  • Patients categorized into four groups based on ΔAlb levels: <5 g/L, 5-9.9 g/L, 10-14.9 g/L, and ≥15 g/L.
  • Primary endpoint: postoperative 30-day mortality.

Main Results:

  • A median ΔAlb of 7.3 g/L was observed.
  • Increased ΔAlb significantly correlated with higher 30-day mortality (ORs ranging from 1.93 to 7.26, P < 0.01).
  • ΔAlb >5 g/L was a strong predictor of mortality, even with nadir albumin >30 g/L (OR 1.84, P = 0.014).

Conclusions:

  • A mild increase in ΔAlb is associated with increased 30-day mortality after brain tumor craniotomy.
  • ΔAlb predicts mortality even when nadir albumin levels remain above 30 g/L.
  • ΔAlb also correlates with postoperative complications and extended hospital stays.