The role of preoperative albumin and white blood cell count in surgical site infections following whipple surgery

• Authors: Mohamad Ali Tfaily, Emory University; Paola Ghanem, Johns Hopkins University,; Sarah H Farran, American University of Beirut; Fatema Dabdoub, American University of Beirut Medical Center; Zeina A Kanafani, American University of Beirut Medical Center
• Journal Title: Scientific Reports
• Volume: Volume 1
• Publisher: Nature Publishing Group | 2022-11-10
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1038/s41598-022-21849-2
• Subjects: Health Sciences, Oncology
• Keywords: Diseases; Infectious diseases; Microbiology; Bacteria

Abstract

Whipple surgery is associated with a high risk of surgical sites infections (SSIs). Nutritional deficiency has been associated with an increased risk of wound infections. This study aims at exploring the role of preoperative albumin levels in predicting the risk of SSIs following Whipple surgery. A total of 23,808 individuals were identified from the ACS-NSQIP database from years 2011 to 2017. The primary exposure was pre-operative albumin while the secondary exposure was white blood cell (WBC) count. The primary outcome was divided into superficial and deep surgical site infections (S/D SSI) and organ-space SSI. All statistical analyses were conducted using IBM Statistical Package for Social Sciences version 26. Levels of pre-operative serum albumin less than 3.73 g/L, dirty and contaminated wounds and longer operative time were associated with increased odds for developing S/D SSIs (OR = 1.14, OR = 1.17, OR = 1.06, respectively, p-value < 0.05). Pre-operative WBC level (/L) was associated with a risk of developing an organ-space SSI but not S/D SSI (OR = 1.02, p-value  0.003). This study demonstrates the predictive role of pre-operative albumin in developing S/D SSIs and highlights the need to develop therapeutic strategies to optimize the pre-operative nutritional health status of patients undergoing Whipple surgery.