Preoperative Albumin Is Predictive of Early Postoperative Morbidity and Mortality in Common Urologic Oncologic Surgeries.

Abstract Introduction Multiple studies have linked preoperative nutrition status to postoperative outcomes. This relationship has been little studied in urology. We used a standardized, national, risk-adjusted surgical database to evaluate 30-day outcomes of patients undergoing common urologic oncologic procedures as they related to preoperative albumin. Methods The American College of Surgeons National Surgical Quality Improvement Program is a risk-adjusted dataset analyzing preoperative risk factors, demographics, and 30-day outcomes. From 2005 through 2012, we identified a total of 17,805 patients who underwent prostatectomy, nephrectomy, partial nephrectomy, cystectomy, or transurethral resection of bladder tumor (TURBT). Hypoalbuminemic patients were compared with those with normal preoperative albumin, and 30-day outcomes were evaluated. Logistic regression analyses were used to estimate odds ratios for mortality and complication rates. Results Evaluation of the cohort noted significantly increased overall morbidity, serious morbidity, and mortality in the hypoalbuminemic group ( P P P Conclusions The large sample size, standardized data definitions, and quality control measures of the American College of Surgeons National Surgical Quality Improvement Program database allow for in-depth analysis of subtle but significant differences in outcomes between groups. Serum albumin is a strong predictor of short-term postoperative complications in the urologic oncology patient.