Rutgers New Jersey Medical School Woodbridge, New Jersey
Objectives: Hypoalbuminemia has been used as a proxy for poor nutrition, and has been associated with poor postoperative outcomes in various surgical procedures. As Zenker’s diverticulectomy is often performed in the elderly, who are more prone to malnutrition, we sought to study the association between hypoalbuminemia and postoperative outcomes in these patients.
Study Design: Retrospective database review.
Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for patients who underwent Zenker’s diverticulectomy between 2005 and 2018. Patients with missing albumin information were excluded. A cutoff of 3.5g/dl was utilized to stratify patients into hypoalbuminemia (3.5g/dl) and normal albumin (>3.5g/dl) cohorts. Univariate and multivariate analyses were conducted.
Results: A total of 318 patients undergoing Zenker’s diverticulectomy met inclusion criteria. The mean serum albumin was 3.90 g/dL (SD=0.56) with 77 patients (24.2%) having hypoalbuminemia. Independent samples t-test demonstrated hypoalbuminemia patients were older (77.7 vs. 70.0 years, p<0.001), had longer hospital length of stay (8.01 vs. 3.58 days, p<0.001), and shorter operation times (87.58 vs. 107.50 minutes, p=0.035). Univariate analysis showed that hypoalbuminemia was associated with medical complication (p < 0.001), life-threatening complications (p=0.017), and mortality (p=0.012). On multivariate analysis, these associations did not persist between hypoalbuminemia and mortality (OR 33.136, 95% CI N/A, p=1.000), medical complications (OR 1.154, 95% CI 0.326-4.079, p=0.824), life-threatening complication (OR 0.604, 95% CI 0.079-4.586, p=0.604), and length of stay (p=0.249).
Conclusions: This study found no association between hypoalbuminemia and postoperative complications in patients undergoing Zenker’s diverticulectomy.