Int J Med Sci 2023; 20(5):663-668. doi:10.7150/ijms.81884 This issue Cite

Research Paper

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

Won Seok Nam, MD1*, Myung Il Bae, MD1*, Sang Beom Nam, MD1,2, Suk Won Song, MD, PhD3, Arim Jo, MD1, Sung Yeon Ham, MD, PhD1,2✉

1. Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea
2. Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
3. Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea
*These authors contributed equally to this work

Citation:
Nam WS, Bae MI, Nam SB, Song SW, Jo A, Ham SY. Prognostic Value of Serum Albumin in Aortic Aneurysm Patients Undergoing Graft Replacement of Ascending Aorta and Aortic Arch. Int J Med Sci 2023; 20(5):663-668. doi:10.7150/ijms.81884. https://www.medsci.org/v20p0663.htm
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Abstract

Graphic 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.

Keywords: Hypoalbuminemia, prognosis, thoracic aortic aneurysm, graft replacement, mortality


Citation styles

APA
Nam, W.S., Bae, M.I., Nam, S.B., Song, S.W., Jo, A., Ham, S.Y. (2023). Prognostic Value of Serum Albumin in Aortic Aneurysm Patients Undergoing Graft Replacement of Ascending Aorta and Aortic Arch. International Journal of Medical Sciences, 20(5), 663-668. https://doi.org/10.7150/ijms.81884.

ACS
Nam, W.S.; Bae, M.I.; Nam, S.B.; Song, S.W.; Jo, A.; Ham, S.Y. Prognostic Value of Serum Albumin in Aortic Aneurysm Patients Undergoing Graft Replacement of Ascending Aorta and Aortic Arch. Int. J. Med. Sci. 2023, 20 (5), 663-668. DOI: 10.7150/ijms.81884.

NLM
Nam WS, Bae MI, Nam SB, Song SW, Jo A, Ham SY. Prognostic Value of Serum Albumin in Aortic Aneurysm Patients Undergoing Graft Replacement of Ascending Aorta and Aortic Arch. Int J Med Sci 2023; 20(5):663-668. doi:10.7150/ijms.81884. https://www.medsci.org/v20p0663.htm

CSE
Nam WS, Bae MI, Nam SB, Song SW, Jo A, Ham SY. 2023. Prognostic Value of Serum Albumin in Aortic Aneurysm Patients Undergoing Graft Replacement of Ascending Aorta and Aortic Arch. Int J Med Sci. 20(5):663-668.

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