A low serum albumin concentration is a well-known prognostic factor. Ryan et al identified hypoalbuminemia on the day following an esophagectomy as a major risk indicator for serious complications. The authors are from St. Jame's Hospital in Dublin.


Patient selection: post-esophagectomy


Indicator: serum albumin < 20 g/L on the first post-operative day



(1) ARDS or respiratory failure

(2) in-hospital mortality

(3) other major complications (sepsis, renal failure, multi-organ failure, heart failure, pneumonia/empyema, surgical site infection, pulmonary embolism, anastomotic leak, etc)


Additional risk factors for post-operative complications:

(1) female gender

(2) current or ex-smoker


In many cases these findings will be known preoperatively. Hemodilution during and after surgery would be an explanation for a low albumin that can not be predicted preoperatively.


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