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Prognostic Value of Serum Albumin in Aortic Aneurysm Patients Undergoing Graft Replacement of Ascending Aorta and Aortic Arch

Authors
 Won Seok Nam  ;  Myung Il Bae  ;  Sang Beom Nam  ;  Suk Won Song  ;  Arim Jo  ;  Sung Yeon Ham 
Citation
 INTERNATIONAL JOURNAL OF MEDICAL SCIENCES, Vol.20(5) : 663-668, 2023-04 
Journal Title
INTERNATIONAL JOURNAL OF MEDICAL SCIENCES
Issue Date
2023-04
Keywords
Hypoalbuminemia ; prognosis ; thoracic aortic aneurysm ; graft replacement ; mortality
Abstract
Background: Hypoalbuminemia is a marker of poor overall health with influences from protein energy
malnutrition, systemic inflammation and hepatic and renal disease. Albumin has been reported to have a prognostic impact in various cohorts. This study investigated whether preoperative serum albumin levels could be used to predict mortality in patients with aortic aneurysms undergoing graft replacement of ascending aorta and aortic arch.

Methods: We retrospectively reviewed 183 patients who underwent graft replacement of ascending
aorta and aortic arch between January 2010 and December 2020. The exclusion criteria included patients with traumatic aortic injuries (n=2), previous aortic repair within 6 months (n=2), ruptured aortic aneurysms (n=14), or a lack of preoperative laboratory data or medical records (n=10). The remaining 87% eligible patients were divided into two groups based on their preoperative serum albumin levels. The lower albumin group was defined as having serum albumin levels ≤3.5 g/dL, while the higher albumin group was defined as having albumin levels >3.5 g/dL. The incidence of mortality was compared between
the two groups, and a logistic regression analysis was performed to evaluate the predictors of mortality.

Results: The incidence of 1-year mortality was higher in the lower albumin group than in the higher albumin group (3.4% vs. 23.5%, p=0.006). The optimal cut-off value of albumin to predict 1-year mortality was 4.0 g/dL (area under the curve 0.885, 95% CI 0.821–0.949, p<0.001), with a sensitivity and specificity of 90.0% and 80.3%, respectively. Preoperative serum albumin levels (OR = 0.116, 95% CI 0.021-0.641, p=0.014) and diabetes mellitus (OR = 5.757, 95% CI 1.018-32.565, p=0.048) remained independent predictors of mortality.

Conclusion: Preoperative serum albumin levels were an independent predictor of 1-year mortality after
the graft replacement of ascending aorta and aortic arch. These findings underscore that the optimization of patients' nutritional status before surgery may be warranted and should be further explored in this high-risk population.
Files in This Item:
T202302183.pdf Download
DOI
10.7150/ijms.81884
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Nam, Sang Beom(남상범) ORCID logo https://orcid.org/0000-0002-9704-1866
Bae, Myung Il(배명일)
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Ham, Sung Yeon(함성연) ORCID logo https://orcid.org/0000-0001-8619-4595
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/194120
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