PREOPERATIVE SERUM ALBUMIN AS A PREDICTOR OF POST OPERATIVE MORBIDITY AND MORTALITY IN PATIENTS OF PERFORATION PERITONITIS.

Background: Perforation peritonitis is the most common surgical emergency encountered in India. Due to late presentation, perforations lead to diffuse peritonitis, resulting in high morbidity and mortality.Assessment of nutritional status of these patients can help in reducing the adverse outcomes.Serum albumin level is a readily available clinical parameter that gives an insight to patients’ nutritional status. In this study, we used pre-operative serum albumin level to assess post-operative outcomes in patients of perforation peritonitis who underwent emergency laparotomy. Methodology: This prospective observational study was conducted in the Department of General Surgery at Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Amritsar. 70 patients were included in the study. Pre-operative serum albumin levels were obtained and correlation was drawn with the post-operative outcomes in terms of delayed wound healing, wound dehiscence, surgical site infection and 30 day mortality. Results: In our study, out of 70 patient, 87.1% had hypoalbuminemia. The mean serum albumin of patients with normal wound healing was statistically more than that of patients with delayed wound healing. As per Southampton Grading System, statistically significant SSI were encountered among patients with hypoalbuminemia. Statistically significant number of patients with hypoalbuminemia had wound dehiscence according to WUWHS-SWD wound grading system. Additionally, statistically significant mortality was observed in patients having pre-operative hypoalbuminemia. Conclusion: Pre-operative serum albumin levels can be used as a clinical parameter to predict post-operative outcomes in patients undergoing emergency laparotomy for perforation peritonitis. [ABSTRACT FROM AUTHOR]