Serum Levels of Prealbumin and Albumin for Preoperative Risk Stratification

Preoperative risk stratification has long been developed as a strategy to predict postoperative outcomes and potentially alter or optimize comorbidities and modifiable risk. Malnutrition is among the most common potentially modifiable risk factors and the strongest predictor of poor postsurgical out...

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Bibliographic Details
Published in:Nutrition in clinical practice 2019-06, Vol.34 (3), p.340-348
Main Authors: Loftus, Tyler J., Brown, Michelle P., Slish, John H., Rosenthal, Martin D.
Format: Article
Language:English
Subjects:
albumin
Biomarkers - blood
Humans
Inflammation - blood
malnutrition
Malnutrition - blood
Malnutrition - complications
Nursing
Nutrition Assessment
patient outcome assessment
Postoperative Complications
prealbumin
Prealbumin - analysis
Preoperative Period
risk
Risk Factors
Sensitivity and Specificity
Serum Albumin - analysis
surgery
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Summary:Preoperative risk stratification has long been developed as a strategy to predict postoperative outcomes and potentially alter or optimize comorbidities and modifiable risk. Malnutrition is among the most common potentially modifiable risk factors and the strongest predictor of poor postsurgical outcomes. Historically, malnutrition has been difficult to address for healthcare providers because of the lack of a cohesive definition. Adding to the confusion has been the use of serum levels of albumin and prealbumin as biomarkers for malnutrition; many fail to understand that these visceral proteins are only valid as markers of nutrition status while at homeostasis. Surgical need is often driven by both sterile and non‐sterile inflammation, but during this pathologic mechanism, hepatic reprioritization shunts visceral protein synthesis, rendering albumin and prealbumin invalid as biomarkers for malnutrition. Ultimately, understanding these limitations and embracing better indicators of malnutrition will improve preoperative risk stratification.
ISSN:0884-5336
1941-2452
DOI:10.1002/ncp.10271