Abstract 410P
Background
In malnourished patients with colorectal cancer (CRC), hypoalbuminemia is common and was proposed to determine the postoperative outcome of colorectal surgery. Mounting articles published but have not been evaluated. Our aim is to evaluate the predictive value of preoperative hypoalbuminemia in patients undergoing colorectal surgery.
Methods
We performed a literature search from ProQuest, PubMed, EuroPMC, and EMBASE with the terms serum albumin, hypoalbuminemia, prognosis, outcome, colorectal cancer, and neoplasm. We also hand-searched and included any relevant papers. Hypoalbuminemia defined as plasma albumin level < 3.5 mg/dL. We restricted the included studies to English language and adults undergoing colectomy, laparotomy, laparoscopy, or abdominoperineal resection. Any types of articles were included, except an abstract-only publication and those that did not report the key exposure or outcome of interest. The key exposures were mortality, hospitalization time, and morbid conditions (thrombosis, surgical site infection [SSI], sepsis, and wound events). We pooled the odds ratio from each included literature as effect size. The Newcastle-Ottawa Scale (NOS) and GRADE were used to determine the quality of each included study.
Results
Hereof 8 observational studies (236,480 individuals) were included. All study shoed that preoperative hypoalbuminemia can predict the postoperative outcome in CRC pateints. Individuals with hypoalbuminemia was associated with 30-day mortality (OR 1.84 [1.72, 1.96], p<0.00001, I2 = 99%), increased length of stay (OR 1.98 [1.80, 2.19], p=0.08, I2 = 60%), SSI (OR1.26 [1.22, 1.31], p<0.00001, I2 = 92%), venous thrombosis (OR 2.35 [2.15, 2.57], p=0.02, I2 = 69%), sepsis (OR 2.44 [2.32, 2.57], p<0.00001, I2 = 97%), and wound event (OR 1.64 [1.50, 1.79], p=0.03, I2 = 62%). According to GRADE, the included studies for this systematic review and meta-analysis are of moderate quality as the results are consistent and no variability observed, and there are few publication biases.
Conclusions
The meta-analysis showed that preoperative hypoalbuminemia was significantly associated with poor postoperative outcomes, making it a promising biomarker.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Jeremiah Hilkiah Wijaya.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.