Predictive value of preoperative serum albumin levels on outcomes in patients undergoing LVAD implantation

Andre C. Critsinelis, Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Vei Vei Lee, Andrew B. Civitello, Jeffrey A. Morgan

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: We performed a single-center retrospective analysis to determine whether preoperative serum albumin levels were associated with postoperative adverse events and short- and long-term survival in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. Methods: From November 2003 through March 2016, 526 patients underwent CF-LVAD implantation. Patients whose preoperative serum albumin level was normal (≥3.5 g/dL) were compared to patients with preoperative hypoalbuminemia (<3.5 g/dL), which was further categorized as moderate (2.5-3.5 g/dL) or severe (<2.5 g/dL). These groups were compared regarding preoperative demographics, incidence of postoperative complications, and long-term survival. Results: Patients with hypoalbuminemia had higher serum levels of liver enzymes (P < 0.05) and total bilirubin (P < 0.001) and significantly lower platelet counts (P = 0.02) and prealbumin levels (P < 0.001) than patients with normal preoperative albumin levels. Survival in patients with moderate and severe preoperative hypoalbuminemia was significantly decreased compared with patients with normal preoperative serum albumin levels (P < 0.001). Preoperative hypoalbuminemia was also associated with higher incidences of postoperative infection, gastrointestinal bleeding, neurological dysfunction, and acute kidney injury (P ≤ 0.01 for all) but did not affect the success of bridge to transplantation or survival after transplantation. Conclusions: Our data demonstrated that there is a significant association of preoperative low serum albumin levels with postoperative adverse outcomes and lower survival rates. This highlights the importance of a patient's preoperative nutritional status on postoperative outcomes after CF-LVAD implantation.

Original languageEnglish (US)
Pages (from-to)469-478
Number of pages10
JournalJournal of Cardiac Surgery
Volume33
Issue number8
DOIs
Publication statusPublished - Aug 2018
Externally publishedYes

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Keywords

  • heart failure
  • hypoalbuminemia
  • left ventricular assist device
  • outcomes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Critsinelis, A. C., Kurihara, C., Kawabori, M., Sugiura, T., Lee, V. V., Civitello, A. B., & Morgan, J. A. (2018). Predictive value of preoperative serum albumin levels on outcomes in patients undergoing LVAD implantation. Journal of Cardiac Surgery, 33(8), 469-478. https://doi.org/10.1111/jocs.13745