• Eun-Ho Lee, Ji-Hyun Chin, Dae-Kee Choi, Bo-Young Hwang, Suk-Jung Choo, Jun-Gol Song, Tae-Yop Kim, and In-Cheol Choi.
• Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
• J. Cardiothorac. Vasc. Anesth.. 2011 Jun 1;25(3):462-8.

ObjectiveThe authors aimed to investigate whether immediate postoperative hypoalbuminemia could be associated with outcomes after off-pump coronary artery bypass graft (OPCAB) surgery.DesignA retrospective analysis of the medical data.SettingCardiac operating room and adult cardiovascular intensive care unit at a single institution.ParticipantsSix hundred ninety adult patients underwent elective OPCAB surgery over a 30-month period.InterventionsNone.Measurements And Main ResultsTo evaluate the clinical relevance of immediate postoperative hypoalbuminemia, the lowest serum albumin level measured over the first 12 hours postoperatively was recorded. A cutoff point was calculated by the area under the curve in the receiver operating characteristic plot for 30-day adverse events including death. Patients were classified according to the cutoff value, and outcomes were compared between groups using propensity score-matching analysis. The impact of immediate postoperative hypoalbuminemia on OPCAB outcome was investigated using multivariate analysis. The cutoff value for immediate postoperative albumin concentration for predicting 30-day adverse events was 2.3 g/dL. Immediate postoperative hypoalbuminemia (<2.3 g/dL) was associated independently with postoperative respiratory failure (odds ratio [OR] = 8.85, p = 0.04), wound infection (OR = 4.44, p = 0.04), the need for an intra-aortic balloon pump after the operation (OR = 13.7, p = 0.02), renal failure (OR = 7.98, p = 0.01), reoperation for bleeding (OR = 4.33, p = 0.05), and the need for inotropes in the intensive care unit (OR = 1.79, p = 0.02).ConclusionsImmediate postoperative hypoalbuminemia was associated with poorer outcomes in OPCAB patients. Monitoring of albumin levels after OPCAB could identify patients at risk for short-term adverse events.Copyright © 2011 Elsevier Inc. All rights reserved.

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