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Is Postoperative Albumin Level Related with Surgical Site Infection?
Surg Metab Nutr 2018;9(2):59-67
Published online December 30, 2018
© 2018 The Korean Society of Surgical Metabolism and Nutrition.

Kyungtae CHO, M.D.1, Sung Woo CHO, M.D., Ph.D.1, Sangchul YUN, M.D., Ph.D.1, Suyeon Park, M.S.2

Departments of 1Surgery and 2Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Korea
Correspondence to: Sung Woo CHO, Department of Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea Tel: +82-2-709-9240, Fax: +82-2-749-0499, E-mail:
Received October 5, 2018; Accepted October 26, 2018.
This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Surgical site infection (SSI) is a hospital-acquired infection (HAI) associated with increased mortality, length of hospital stay, and cost of hospitalization. The aim of this study was to identify the value of albumin as an indicator of the nutritional status, postoperative C-reactive protein (CRP), and white blood cell (WBC) levels in predicting an outbreak of SSI and SSI-related epidemiology after colorectal surgery and identifying the risk factors for SSI.
Materials and Methods: A total of 198 patients, who underwent colorectal surgery from September 1, 2015 to December 31, 2016, were included in the study. The patient identity, operation characteristics, and SSI data were analyzed retrospectively by a chart review and national SSI reporting sheet. The relationship of the SSI and clinical data was analyzed statistically, and the SSI detection time and post-operative inflammatory laboratory findings were analyzed individually using cumulative incidence analysis and cause-specific hazard model.
Results: The incidence of SSI post colorectal surgery was 15.7% (31 out of 198 cases). Chronic renal failure (CRF), open surgery, long operation time, and stoma were identified as significant risk factors for SSI using univariate analysis. The CRF, long operation time, and stoma were significant risk factors according to multivariate analysis. The decrease in albumin on post-operative day (POD)#3 and CRP elevation on POD#4 were related to the early detection of SSI.
Conclusion: The actual incidence of SSI might be higher than expected, particularly in cases where patients have several clinical and operative factors. In addition, the albumin level and multiple postoperative inflammation tests can be employed as an early predictors of SSI.
Keywords : Surgical site infection, Colorectal surgery, Risk factors

December 2018, 9 (2)
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