Perioperative medicine & outcomes
Postoperative Complications Associated with Preoperative Hypoalbuminaemia in Gastrointestinal Surgery Patients: A Systematic Review and Meta-Analysis
Pooled result · 30-day mortalityResult — go to the resultRelative risk 3.37 95% CI 2.59–4.37Authors' conclusion
Preoperative hypoalbuminaemia is associated with increased mortality, morbidity, and healthcare utilisation in gastrointestinal surgery. As the primary associations derive from unadjusted observational data, preoperative albumin is best interpreted as a marker of perioperative risk rather than a proven modifiable target. Whether interventions that correct hypoalbuminaemia improve postoperative outcomes requires further research.
Study context
- Population
- Gastrointestinal surgery patients, hypoalbuminaemic and normoalbuminaemic42 studies
- Comparison
- Adverse outcomes between hypoalbuminaemic and normoalbuminaemic patients
- Outcome
- 30-day mortality
- Follow-up
- 30-day
Pooled result
As reported in the abstract
Relative risk
3.37
95% CI 2.59–4.37
Hypoalbuminaemic patients vs Normoalbuminaemic patients
RR 3.37 (95% CI 2.59–4.37)
Further pooled results
| Outcome | RR | |
|---|---|---|
| All-cause complications49% higher | 1.49 (95% CI 1.33–1.68) | |
| Readmission | 1.38 (CI 1.22–1.57) | |
| Reoperation | 1.32 (CI 1.22–1.43) | |
| Non-home discharge | 1.51 (CI 1.28–1.78) | |
| Cardiovascular complications | 1.75 (CI 1.41–2.17) | |
| Respiratory complications | 2.15 (CI 1.79–2.58) | |
| Infectious complications | 1.72 (CI 1.47–2.01) | |
| Thromboembolic complications | 2.00 (CI 1.76–2.27) | |
| 0.20.5125Relative risk (log scale) |
| Outcome | Difference, longer (prolonged) in Hypoalbuminaemic patients (days) (CI) | |
|---|---|---|
| Hospital length of stay | 3.02 (1.63–4.41) | |
| −20246Difference, days (linear scale) |
- Hospital length of stay: hospital length of stay was prolonged by 3.02 days in hypoalbuminaemic patients
- Thromboembolic complications: Between-study heterogeneity was substantial, and prediction intervals were wide.
Prevalence of preoperative hypoalbuminaemia (descriptive)
- Overall
- 10.3%
- Bariatric surgery
- 5.5%
- Non-bariatric surgery populations
- 17.1%
Original publication
Postoperative Complications Associated with Preoperative Hypoalbuminaemia in Gastrointestinal Surgery Patients: A Systematic Review and Meta-Analysis. Anaesth Crit Care Pain Med. Published 6 October 2026. doi:10.
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